NPI | 1912178336 |
---|---|
Entity Type | Organization |
Authorized Contact | MARSHA DONALDSON Vice President 904-376-3703 |
Organization Subpart ? | No |
Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: FL ME64742) |
Enumeration Date | 2008-03-13 |
Last Update Date | 2018-12-14 |