| 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 |