| NPI | 1962857417 |
|---|---|
| Other Name | PORT ST JOHN CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANGELA CRAIG Business Office Manager 321-241-6834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-06-17 |