| NPI | 1700099017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB GREEN CEO, Neurologist 904-346-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0013636) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 59265) |
| 174400000X Specialist (Licence: FL ME45606) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-05-20 |