| NPI | 1801021787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS MICHAEL KLEINER CEO 904-328-2238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME 80275) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL EMT 300287) |
| 163W00000X Registered Nurse (Licence: FL RN 9182095) | |
| 246Z00000X Specialist/Technologist, Other (Licence: FL AL 377) | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-05-21 |