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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

NPI # 1710940648
LBN Legal business name ANASTASIA MEDICAL GROUP, LLC
Authorized official SUHAS NEERUKONDA - (MANAGING PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/11/2006
Last updated 01/15/2024 - About 2 years ago
Identifiers
FL Medicaid 277020200
FL Other 99767 BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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