| NPI | 1760591952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN SOLOMON Managing Employee 904-273-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 10-C001394) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1156) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-04-25 |