NPI 1710940648 · live from the CMS NPI Registry
Anastasia Medical Group, LLC
Internal Medicine in St Augustine, FL. National Provider Identifier 1710940648, active.
NPI record
| NPI | 1710940648 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 1301 Plantation Island Drive, Suite 203a, St Augustine, FL 32080 |
| Practice phone | 904-461-0821 |
| Enumerated | April 11, 2006 |
| Last updated | January 15, 2024 |
| Authorized official | Suhas Neerukonda, Managing Partner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Endocrinology, Diabetes & Metabolism | 207RE0101X | — |
| Podiatrist | 213E00000X | — |
| Internal Medicine primary | 207R00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.