| NPI | 1821398066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KAY ROBINSON Surgical Coordinator 904-730-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL me78960) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2010-10-21 |