| NPI | 1851347801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE MCCLOUD Executive Director 904-202-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-12-13 |