| NPI | 1851347801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE MCCLOUD Executive Director 904-202-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 207X00000X Orthopaedic Surgery | |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 207RS0010X Internal Medicine, Sports Medicine | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care | |
| 207Q00000X Family Medicine | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 213E00000X Podiatrist | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2026-04-23 |