| Mccaulie Primary Care P A | |
|
520 A1a N Suite 201 Ponte Vedra Beach FL 32082-5212 | |
| (904) 280-5700 | |
| (904) 280-5703 |
| Full Name | Mccaulie Primary Care P A |
|---|---|
| Speciality | Family Medicine |
| Location | 520 A1a N, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | John Robert Mccaulie (PRESIDENT) |
| Authorized Official Contact | 9042805700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mccaulie Primary Care P A 520 A1a N Suite 201 Ponte Vedra Beach FL 32082-5212 Ph: (904) 280-5700 | Mccaulie Primary Care P A 520 A1a N Suite 201 Ponte Vedra Beach FL 32082-5212 Ph: (904) 280-5700 |
| NPI Number | 1417083171 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 04/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417083171 | NPI | - | NPPES |
| 378911000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME 000054470 (Florida) | Primary |
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