# FM MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053652099
- **Authorized official:** SCOTT ROBERT MICHAELS D.C. (OWNER)
- **Authorized official phone:** (904) 823-8833

## Contact information

- **Practice address:** 165 SOUTHPARK BLVD, SUITE C & D, ST AUGUSTINE, FL 32086-4101
- **Practice address phone:** (904) 823-8833
- **Practice address fax:** (904) 823-9394
- **Mailing address:** 165 SOUTHPARK BLVD, SUITE C & D, ST AUGUSTINE, FL 32086-4101
- **Mailing address phone:** (904) 823-8833
- **Mailing address fax:** (904) 823-9394

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | ME106486 | FL | Yes |

## Other

- **Enumeration date:** 03/14/2013
- **Last updated:** 07/08/2013