| NPI | 1891063509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD DOMINICK TRIBUZIO Owner/Physician 904-261-0643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL flme42515) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |