| NPI | 1710183264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW STEPHEN GEORGE President 904-316-3105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9213136) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL ARNP 9213136) |
| 314000000X Skilled Nursing Facility (Licence: FL ARNP 9213136) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2014-04-09 |