St. Augustine Pediatric Associates, PA

NPI #1447461421 in St Augustine, Florida

Provider Information

NPI Number: 1447461421
Entity Type: Organization
Organization Name: St. Augustine Pediatric Associates, PA
Subpart: Yes (part of a larger organization)
Parent Organization: ST. AUGUSTINE PEDIATRICS
Primary Specialty: Pediatrics
Enumeration Date: May 24, 2007
Last Updated: Jul 21, 2015

Practice Location

Address: 493 PROSPERITY LAKE DR
City: St Augustine
State: Florida
ZIP Code: 32092-5045
Phone: (904) 824-5437

Authorized Official

Name: MICHAEL SOBERANO, M.D.
Title: OWNER
Phone: (904) 824-5437

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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