| Nicole Russo Cavignaro, PA-C | |
|
316 Paseo Reyes Dr, St Augustine, FL 32095-8464 | |
| (904) 544-5800 | |
| (904) 544-5800 |
| Full Name | Nicole Russo Cavignaro |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 316 Paseo Reyes Dr, St Augustine, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508527748 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9117532 (Florida) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bold City Dermatology Llc | 2769897974 | 4 |
| Entity Name | Bold City Dermatology LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538761655 PECOS PAC ID: 2769897974 Enrollment ID: O20210222001927 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Russo Cavignaro, PA-C 316 Paseo Reyes Dr, St Augustine, FL 32095-8464 Ph: (904) 544-5800 | Nicole Russo Cavignaro, PA-C 316 Paseo Reyes Dr, St Augustine, FL 32095-8464 Ph: (904) 544-5800 |
Thomas Alfred John, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 211 Bronson Pkwy, St Augustine, FL 32095 Phone: 904-673-0089 |
Ms. Ergi Spaho, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 316 Paseo Reyes Dr, St Augustine, FL 32095 Phone: 904-554-5800 |
David S Goins, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 Health Park Blvd, St Augustine, FL 32086 Phone: 904-826-4700 Fax: 904-346-0113 |
Brittyn Hamer, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 45 Groover Loop Ste 201, St Augustine, FL 32086 Phone: 904-634-0640 Fax: 904-634-0203 |
Mr. Robert P. Weber, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1100 Plantation Island Dr S Ste 220, St Augustine, FL 32080 Phone: 904-223-3321 Fax: 904-223-2169 |
Richard Axelsen, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 110 Health Park Blvd, St Augustine, FL 32086 Phone: 631-603-7980 |
Ashleigh Elizabeth Maya, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 45 Groover Loop Ste 201, St Augustine, FL 32086 Phone: 904-634-0640 Fax: 904-634-0203 |