| Fm Medical Clinic Llc | |
|
165 Southpark Blvd St Augustine FL 32086-4101 | |
| (904) 823-8833 | |
| (904) 823-9394 |
| Full Name | Fm Medical Clinic Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 165 Southpark Blvd, St Augustine, Florida |
| Authorized Official Name and Position | Scott R Michaels (CLINIC DIRECTOR) |
| Authorized Official Contact | 9048238833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fm Medical Clinic Llc 165 Southpark Blvd St Augustine FL 32086-4101 Ph: (904) 823-8833 | Fm Medical Clinic Llc 165 Southpark Blvd St Augustine FL 32086-4101 Ph: (904) 823-8833 |
| NPI Number | 1891298790 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891298790 | NPI | - | NPPES |
| M242796603210 | Other | FL | DRIVERS LICENSES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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