| Jacksonville Pediatrics World Golf Village Pllc | |
|
130 Land Grant Street Suite 3 St Augustine FL 32092 | |
| (904) 388-4646 | |
| Not Available |
| Full Name | Jacksonville Pediatrics World Golf Village Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 130 Land Grant Street, St Augustine, Florida |
| Authorized Official Name and Position | Ryan C Cantville (PHYSICIAN) |
| Authorized Official Contact | 9043884646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Pediatrics World Golf Village Pllc 2606 Park St Jacksonville FL 32204-4520 Ph: (904) 388-4646 | Jacksonville Pediatrics World Golf Village Pllc 130 Land Grant Street Suite 3 St Augustine FL 32092 Ph: (904) 388-4646 |
| NPI Number | 1275329823 |
|---|---|
| Provider Enumeration Date | 04/18/2025 |
| Last Update Date | 04/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275329823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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