| St Augustine Physical Medicine | |
|
1100 S Ponce De Leon Blvd Suite 3-a St Augustine FL 32084-6099 | |
| (904) 429-7071 | |
| Not Available |
| Full Name | St Augustine Physical Medicine |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1100 S Ponce De Leon Blvd, St Augustine, Florida |
| Authorized Official Name and Position | James L Solana (PRESIDENT) |
| Authorized Official Contact | 9044297071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Augustine Physical Medicine 1100 S Ponce De Leon Blvd Suite 3-a St Augustine FL 32084-6099 Ph: (904) 429-7071 | St Augustine Physical Medicine 1100 S Ponce De Leon Blvd Suite 3-a St Augustine FL 32084-6099 Ph: (904) 429-7071 |
| NPI Number | 1568798965 |
|---|---|
| Provider Enumeration Date | 10/20/2009 |
| Last Update Date | 10/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568798965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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