| NPI | 1861089062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL BUSQUETS Owner 904-621-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2021-09-30 |