Organization
HORMONE HEALTH AND WEIGHT LOSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SCOTT CHASTAIN (OWNER)
(904) 527-2000
Entity
Organization
Contact information
Practice address
11363 SAN JOSE BLVD, ST. 102, JACKSONVILLE, FL 32223-7957
(904) 527-2000
(904) 527-2001
Mailing address
11363 SAN JOSE BLVD, ST. 102, JACKSONVILLE, FL 32223-7957
(904) 527-2000
(904) 527-2001
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
604198
FL
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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