ST JOHNS CARDIOVASCULAR PA NPI 1194926626

NPI Information

NPI: 1194926626
Provider Name: ST JOHNS CARDIOVASCULAR PA
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
300 HEALTH PARK BLVD
STE 1000
ST AUGUSTINE, FL
ZIP 32086
Phone: (904) 810-1045
Get Directions

ST JOHNS CARDIOVASCULAR PA is a cardiovascular disease internal medicine in St Augustine, FL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. ST JOHNS CARDIOVASCULAR PA NPI is 1194926626. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 HEALTH PARK BLVD
STE 1000
ST AUGUSTINE, FL
ZIP 32086-707
Phone: (904) 810-1045
Fax: (904) 810-1046

The provider's authorized official is Howard A Baker .
The authorized official title is President and has the following contact phone number (904) 810-1045.

The enumeration date for this NPI number is 5/31/2007 and was last updated on 1/11/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	ME45744	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DG3336	OTHER	FLORIDA	RR MEDICARE
2	0636515100	MEDICAID	FLORIDA
3	AE615	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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