| NPI | 1922335389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR A MAQUERA President 904-276-1663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME59449) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2012-01-24 |