| NPI | 1679896401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA J MILLER Off Manager 904-396-5428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL me13018) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-03-08 |