First Coast Ltc, INC

NPI #1538418868 in Saint Johns, Florida

Provider Information

NPI Number: 1538418868
Entity Type: Organization
Organization Name: First Coast Ltc, INC
Subpart: Yes (part of a larger organization)
Parent Organization: FIRST COAST LTC, INC
Primary Specialty: General Practice
Enumeration Date: Aug 31, 2012
Last Updated: Mar 7, 2016

Practice Location

Address: 25 STATE ROAD 13
Address 2: ATT: CLINIC
City: Saint Johns
State: Florida
ZIP Code: 32259-2842
Phone: (904) 309-6504

Authorized Official

Name: DR. DAVID SAMARA, MD
Title: PRESIDENT
Phone: (904) 309-6504

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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