| NPI | 1912898073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADI CHALHOUB Owner 904-304-7404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-15 |