Seacoast Health | |
4856 First Coast Hwy Ste 1 Fernandina Beach FL 32034-5495 | |
(904) 229-5038 | |
(904) 592-5343 |
Full Name | Seacoast Health |
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Speciality | Clinic/Center |
Location | 4856 First Coast Hwy Ste 1, Fernandina Beach, Florida |
Authorized Official Name and Position | Gregory Devon Miller (OWNER) |
Authorized Official Contact | 9042295038 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Seacoast Health 4856 First Coast Hwy Ste 1 Fernandina Beach FL 32034-5495 Ph: (904) 229-5038 | Seacoast Health 4856 First Coast Hwy Ste 1 Fernandina Beach FL 32034-5495 Ph: (904) 229-5038 |
NPI Number | 1902436975 |
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Provider Enumeration Date | 01/18/2020 |
Last Update Date | 03/27/2023 |
Certification Date | 03/27/2023 |
Medicare PECOS PAC ID | 2466887187 |
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Medicare Enrollment ID | O20200127000503 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902436975 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Gregory Devon Miller |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1427317825 PECOS PAC ID: 9335366186 Enrollment ID: I20160629000056 |
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