Provider First Line Business Practice Location Address:
6271 ST. AUGUSTINE ROAD
Provider Second Line Business Practice Location Address:
UFJP PEDIATRIC AND ADOLESCENT CENTER
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-633-0460
Provider Business Practice Location Address Fax Number:
904-633-0461
Provider Enumeration Date:
06/11/2006