# LIGHTHOUSE PAIN AND SPINE SPECIALISTS

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

## Provider details

- **NPI number:** 1104903160
- **Authorized official:** JOHN DOYLE MD (OWNER)
- **Authorized official phone:** (904) 824-4990

## Contact information

- **Practice address:** 300 HEALTH PARK BLVD, SUITE 5008, ST AUGUSTINE, FL 32086-3707
- **Practice address phone:** (904) 823-8823
- **Mailing address:** PO BOX 3012, ST AUGUSTINE, FL 32085-3012
- **Mailing address phone:** (904) 824-4990
- **Mailing address fax:** (904) 824-2226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | ME97111 | FL | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020