| NPI | 1689063406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN JAMES WILEY President 904-758-8020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 0111390) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2016-04-26 |