| NPI | 1871879841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANDREW ILLOVSKY Chief Executive Officer 904-315-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME74432) |
| Enumeration Date | 2011-10-22 |
| Last Update Date | 2013-08-01 |