| NPI | 1952738981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIPUL R PATEL Director 904-487-8320 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL ME57227) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: FL ME57227) |
| 208D00000X General Practice | |
| 207R00000X Internal Medicine | |
| 207R00000X Internal Medicine (Licence: FL ME121788) | |
| 207Q00000X Family Medicine (Licence: FL ME121788) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: FL ME121788) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: FL ME121788) | |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2017-01-09 |