| NPI | 1780071613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ANTONIO-MIRANDA Owner 904-269-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: FL ME74314) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |