| NPI | 1992365472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL KANTOR Chief Medical Officer 904-687-7879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |