| St Augustine Adult & Pediatric Medicine Pa | |
|
67 S Dixie Hwy St Augustine FL 32084-0317 | |
| (904) 827-0032 | |
| (904) 827-0985 |
| Full Name | St Augustine Adult & Pediatric Medicine Pa |
|---|---|
| Speciality | Pediatrics |
| Location | 67 S Dixie Hwy, St Augustine, Florida |
| Authorized Official Name and Position | Vandana Y Bhide (MD) |
| Authorized Official Contact | 9048270032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Augustine Adult & Pediatric Medicine Pa 67 S Dixie Hwy St Augustine FL 32084-0317 Ph: (904) 827-0032 | St Augustine Adult & Pediatric Medicine Pa 67 S Dixie Hwy St Augustine FL 32084-0317 Ph: (904) 827-0032 |
| NPI Number | 1174518179 |
|---|---|
| Provider Enumeration Date | 09/15/2005 |
| Last Update Date | 11/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174518179 | NPI | - | NPPES |
| 252533000 | Medicaid | FL | |
| 41496 | Other | BCBS | |
| 110169538 | Other | RR MC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME73431 (Florida) | Secondary |
| 208000000X | Pediatrics | ME73431 (Florida) | Primary |
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