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Contact Information

ANASTASIA MEDICAL GROUP, LLC
1301 PLANTATION ISLAND DRIVE
SUITE 203A
SAINT AUGUSTINE, FL32080
 Phone: 904-461-0821
 Fax: 904-461-0823
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
 

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ANASTASIA MEDICAL GROUP LLC · (Female)

NPI Number 1710940648
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2006
Last updated 01/15/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL Medicaid 277020200
  • FL Other 99767 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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