# MCCAULIE PRIMARY CARE P A

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1417083171
- **Authorized official:** JOHN ROBERT MCCAULIE MD (PRESIDENT)
- **Authorized official phone:** (904) 280-5700

## Contact information

- **Practice address:** 520 A1A N, SUITE 201, PONTE VEDRA BEACH, FL 32082-5212
- **Practice address phone:** (904) 280-5700
- **Practice address fax:** (904) 280-5703
- **Mailing address:** 520 A1A N, SUITE 201, PONTE VEDRA BEACH, FL 32082-5212
- **Mailing address phone:** (904) 280-5700
- **Mailing address fax:** (904) 280-5703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME 000054470 | FL | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 04/05/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 378911000 | — | FL |