Dr Miguel A Mas Jr, MD | |
1301 Plantation Island Dr S, Suite 404, St Augustine, FL 32080-3108 | |
(904) 461-1560 | |
(904) 461-4304 |
Full Name | Dr Miguel A Mas Jr |
---|---|
Gender | Male |
Speciality | Pediatrics - Adolescent Medicine |
Location | 1301 Plantation Island Dr S, St Augustine, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033273511 | NPI | - | NPPES |
061348700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080A0000X | Pediatrics - Adolescent Medicine | ME52932 (Florida) | Primary |
Entity Name | Ancient City Pediatrics, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053598292 PECOS PAC ID: 0941435176 Enrollment ID: O20131024001004 |
Mailing Address | Practice Location Address |
---|---|
Dr Miguel A Mas Jr, MD 1301 Plantation Island Dr S, Suite 404, St Augustine, FL 32080-3108 Ph: (904) 461-1560 | Dr Miguel A Mas Jr, MD 1301 Plantation Island Dr S, Suite 404, St Augustine, FL 32080-3108 Ph: (904) 461-1560 |
Dr. Shirley N Leadem, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1740 Tree Boulevard, Suite 112, St Augustine, FL 32084 Phone: 904-829-6591 Fax: 904-824-8856 | |
Mr. Gary Wayne Cater, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 400 Health Park Blvd, St Augustine, FL 32086 Phone: 904-819-4478 | |
Dr. Meredith Johnston Brazell, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 120 Palencia Village Dr Ste 107, St Augustine, FL 32095 Phone: 904-819-3200 | |
Kaylan Brady, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 70 Turin Terrace, Suite 220, St Augustine, FL 32092 Phone: 904-819-3000 Fax: 904-819-4426 | |
Paul J Leadem Jr., M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1740 Tree Boulevard, Suite 112, St Augustine, FL 32084 Phone: 904-829-6591 Fax: 904-824-8856 | |
Dr. Patricia Elvir, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 319 W Town Pl, Suite#1, St Augustine, FL 32092 Phone: 904-940-1577 Fax: 904-940-1916 |