| NPI | 1649451295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIRO ANTONIO DE LA HOZ Administrator 904-425-6963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME70797) |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2008-11-19 |