| NPI | 1679240337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA DONALDSON Vice President 904-202-2141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |