| NPI | 1891160859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIT K VIJAPURA Shareholder 904-733-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: FL ME59803) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2015-12-02 |