| NPI | 1821899196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN-MARK MILLER MOORE President 904-655-9223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2025-03-22 |
| Last Update Date | 2025-04-01 |