| 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 |