Provider Type Icon

ST. AUGUSTINE PEDIATRIC ASSOCIATES PA NPI 1447461421


NPI Information

NPI: 1447461421
Provider Name: ST. AUGUSTINE PEDIATRIC ASSOCIATES, PA
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
493 PROSPERITY LAKE DR
ST AUGUSTINE, FL
ZIP 32092
Phone: (904) 824-5437
Get Directions

ST. AUGUSTINE PEDIATRIC ASSOCIATES, PA is a pediatrics in St Augustine, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. ST. AUGUSTINE PEDIATRIC ASSOCIATES, PA NPI is 1447461421. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

493 PROSPERITY LAKE DR
ST AUGUSTINE, FL
ZIP 32092-045
Phone: (904) 824-5437
Fax: (904) 824-7575

The provider's authorized official is Michael Soberano .
The authorized official title is Owner and has the following contact phone number (904) 824-5437.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 7/21/2015.


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
1208000000XPediatricsME78696FLORIDAYes

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
1257545101MEDICAIDFLORIDA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.