| NPI | 1922085059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN BRYANT CFO 904-276-9311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 998) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2020-08-22 |