| North Florida Specialists In Lung Diseases & Internal Medicine Pa | |
|
301 Health Park Blvd Suite # 326 St Augustine FL 32086-5771 | |
| (904) 824-4532 | |
| (904) 824-4024 |
| Full Name | North Florida Specialists In Lung Diseases & Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 Health Park Blvd, St Augustine, Florida |
| Authorized Official Name and Position | Sebastian Josephkutty (PRESIDENT) |
| Authorized Official Contact | 9048244532 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Florida Specialists In Lung Diseases & Internal Medicine Pa 301 Health Park Blvd Suite # 326 St Augustine FL 32086-5771 Ph: (904) 824-4532 | North Florida Specialists In Lung Diseases & Internal Medicine Pa 301 Health Park Blvd Suite # 326 St Augustine FL 32086-5771 Ph: (904) 824-4532 |
| NPI Number | 1982789079 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 11/07/2014 |
| Medicare PECOS PAC ID | 5193750461 |
|---|---|
| Medicare Enrollment ID | O20051005000842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982789079 | NPI | - | NPPES |
| 255224800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Florida) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | (Florida) | Primary |
| Provider Name | Sebastian Josephkutty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598840001 PECOS PAC ID: 9638104904 Enrollment ID: I20051006000072 |
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