| NPI | 1912716135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE STEWART Administrator 904-425-4625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-01-02 |