St Augustine Physical Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ST AUGUSTINE PHYSICAL MEDICINE

Practice address

1100 S Ponce de Leon Blvd
Suite 3-a
St Augustine, FL 32084-6099

Phone

(904) 429-7071

NPI assigned

Oct 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James L Solana Jr.

Title

President

Phone

(904) 429-7071

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1568798965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD",
            "address_2": "SUITE 3-A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846099",
            "telephone_number": "904-429-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD",
            "address_2": "SUITE 3-A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846099",
            "telephone_number": "904-429-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST AUGUSTINE PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "SOLANA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-429-7071",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Augustine FL Opco LLC (The Lilac at Bayview)
• St Augustine FL Opco LLC (The Lilac at Bayview)
• St Augustine Medical Equipment LLC
• St Augustine Neurology PA
• St Augustine Oral & Facial Surgical Center PA
• St Augustine Physicians Associates Inc (Monahan Chiropractic)
• St Augustine Physicians Associates Inc. (Monahan Chiropractic)
• St Augustine Primary Care P L
• St Augustine Senior Living LLC (Tranquil Oaks Assisted Living)
• St Augustine Specialty Healthcare, Inc. (SASH Clinic)

• Primary Care Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.