| NPI | 1801457296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW TERRY President/COO 904-456-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 208600000X Surgery | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2025-03-13 |