| NPI | 1912786963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOT ACKERMAN Owner 904-880-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2024-01-22 |