| NPI | 1891031910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY A MARCOM Doctor 904-268-9266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL OS3739) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |