| NPI | 1710592787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS JESUS RODRIGUEZ Medical Director 904-560-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |