Provider First Line Business Practice Location Address:
11481 OLD SAINT AUGUSTINE RD
Provider Second Line Business Practice Location Address:
UFJP AUGUSTINE OAKS FAMILY PRACTICE CTR
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32258-1402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-260-1818
Provider Business Practice Location Address Fax Number:
904-260-4182
Provider Enumeration Date:
03/24/2006