| NPI | 1841783701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BOSTIC Administrator 904-733-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2018-06-14 |