Your Health Primary Care Of Florida, Llc | |
1301 Plantation Island Dr S Ste 303b St Augustine FL 32080-3117 | |
(803) 457-5129 | |
Not Available |
Full Name | Your Health Primary Care Of Florida, Llc |
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Speciality | Clinic/Center |
Location | 1301 Plantation Island Dr S Ste 303b, St Augustine, Florida |
Authorized Official Name and Position | Matt Staub (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 8037308910 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Your Health Primary Care Of Florida, Llc 111 Doctor Cir Columbia SC 29203-6502 Ph: (803) 457-5129 | Your Health Primary Care Of Florida, Llc 1301 Plantation Island Dr S Ste 303b St Augustine FL 32080-3117 Ph: (803) 457-5129 |
NPI Number | 1659114577 |
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Provider Enumeration Date | 06/18/2024 |
Last Update Date | 06/18/2024 |
Medicare PECOS PAC ID | 0143754135 |
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Medicare Enrollment ID | O20241113003454 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659114577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Sharon Dyan Moreland |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548773005 PECOS PAC ID: 7012275308 Enrollment ID: I20171214000645 |
Provider Name | Astrid Clarke |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1386740595 PECOS PAC ID: 0749383818 Enrollment ID: I20180509001473 |
Provider Name | Larry Little |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134504079 PECOS PAC ID: 2961767363 Enrollment ID: I20180606002252 |
Provider Name | Megan Green |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154020022 PECOS PAC ID: 2466827175 Enrollment ID: I20230412000118 |
Provider Name | Stephanie Lynn Schagrin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962165217 PECOS PAC ID: 8527457142 Enrollment ID: I20240917004474 |
Provider Name | Tiffany Taylor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841032422 PECOS PAC ID: 2961935861 Enrollment ID: I20250114003840 |
Provider Name | Terri Woodruff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477832475 PECOS PAC ID: 7911178793 Enrollment ID: I20250303002313 |
Provider Name | Tara Lyn Madden Wells |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013416718 PECOS PAC ID: 4789926908 Enrollment ID: I20250314002035 |
Provider Name | Maresa Butler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447862909 PECOS PAC ID: 7719397090 Enrollment ID: I20250314002651 |
Provider Name | George Rollins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598116485 PECOS PAC ID: 1153617030 Enrollment ID: I20250318001858 |
Provider Name | Melanie Scianna |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063070316 PECOS PAC ID: 6305273590 Enrollment ID: I20250318003745 |
Provider Name | Brooke Howard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972261550 PECOS PAC ID: 8123419264 Enrollment ID: I20250319003114 |
Provider Name | Jennifer Lynn Haynes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073966024 PECOS PAC ID: 7214224906 Enrollment ID: I20250320000545 |
Provider Name | Christopher Laffey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477265809 PECOS PAC ID: 3173997111 Enrollment ID: I20250325004123 |
Provider Name | Cynthia Dinino |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417615816 PECOS PAC ID: 2860884277 Enrollment ID: I20250401000338 |
Provider Name | Marc Saint-jour |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942592662 PECOS PAC ID: 3476775958 Enrollment ID: I20250401001048 |
Provider Name | Jason Gandy |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1003103730 PECOS PAC ID: 5890238620 Enrollment ID: I20250402001252 |
Provider Name | Stephanie Rich |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609335744 PECOS PAC ID: 3779816616 Enrollment ID: I20250402001481 |
Provider Name | Melissa N Chism |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548799729 PECOS PAC ID: 3476810888 Enrollment ID: I20250404000916 |
Provider Name | Jennifer Burgess |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215621503 PECOS PAC ID: 9931555752 Enrollment ID: I20250506000688 |
Provider Name | Madhannagari Naveen Kumar Reddy |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1235544776 PECOS PAC ID: 5294164877 Enrollment ID: I20250604004217 |
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