| NPI | 1962641498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE CONE Billing Manager 904-406-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL PA2310) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |