| NPI | 1801072756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY GIBSON Office Manager 904-824-3777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME0060293) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2008-01-30 |