| NPI | 1942868377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOURIAL MORRIS SOURIAL President 904-944-2124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2021-05-25 |