| NPI | 1992384739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOXY GABRIELLE BRANCH Practice Manager 904-449-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-04-07 |