| Aza Health | |
|
250 State Road 207 St Augustine FL 32084-0997 | |
| (904) 824-3322 | |
| (904) 810-2004 |
| Full Name | Aza Health |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 250 State Road 207, St Augustine, Florida |
| Authorized Official Name and Position | Laura M Spencer (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3863280108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aza Health 1302 River St Palatka FL 32177-5042 Ph: (386) 328-0108 | Aza Health 250 State Road 207 St Augustine FL 32084-0997 Ph: (904) 824-3322 |
| NPI Number | 1821533175 |
|---|---|
| Provider Enumeration Date | 12/22/2016 |
| Last Update Date | 02/13/2020 |
| Certification Date | 02/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821533175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (NU) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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