| NPI | 1962515437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA GINA TIOMICO-TRAHAN President 904-641-6110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-11-14 |