| NPI | 1710125349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIOSA R ANTIPORDA President 904-713-8074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME47869) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME49981) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |