Provider First Line Business Practice Location Address:
820 PRUDENTIAL DR STE 405
Provider Second Line Business Practice Location Address:
UFJP PEDIATRIC MULTISPECIALTY
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32207-8206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-633-0920
Provider Business Practice Location Address Fax Number:
904-600-0921
Provider Enumeration Date:
03/17/2006