NPI | 1992045207 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTHA G HERRERA Medical Director 904-802-5921 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3568) |
Enumeration Date | 2013-02-22 |
Last Update Date | 2018-01-30 |