| James F Connor Pa | |
|
1851 Old Moultrie Rd Suite A St Augustine FL 32084-4168 | |
| (904) 824-8088 | |
| (904) 826-4105 |
| Full Name | James F Connor Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1851 Old Moultrie Rd, St Augustine, Florida |
| Authorized Official Name and Position | Maria Concepcion Connor (CREDRENTIALING) |
| Authorized Official Contact | 9048248088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James F Connor Pa 1851 Old Moultrie Rd Suite A St Augustine FL 32084-4168 Ph: (904) 824-8088 | James F Connor Pa 1851 Old Moultrie Rd Suite A St Augustine FL 32084-4168 Ph: (904) 824-8088 |
| NPI Number | 1841211018 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 03/13/2020 |
| Medicare PECOS PAC ID | 3870563315 |
|---|---|
| Medicare Enrollment ID | O20040730000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841211018 | NPI | - | NPPES |
| 263119900 | Medicaid | FL | |
| 4283452 | Other | AETNA | |
| 7080262005 | Other | CIGNA | |
| 100699 | Other | AVMED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS5712 (Florida) | Primary |
| Provider Name | James Connor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245250919 PECOS PAC ID: 3678543113 Enrollment ID: I20101214000455 |
| Provider Name | Pamela Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932567021 PECOS PAC ID: 3072819689 Enrollment ID: I20160308002027 |
| Provider Name | Jennifer M Seda Ramirez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912971102 PECOS PAC ID: 9931123171 Enrollment ID: I20161209000293 |
| Provider Name | Eric J Avella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245940352 PECOS PAC ID: 7416326152 Enrollment ID: I20221220000289 |
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