# PHYSICIAN ASSOCIATES GROUP, INC.

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

## Provider details

- **NPI number:** 1730549817
- **Authorized official:** JEREMY MIRABILE MD (MEDICAL DOCTOR)
- **Authorized official phone:** (904) 342-5965

## Contact information

- **Practice address:** 1301 PLANTATION ISLAND DR S, SUITE 201-A, ST AUGUSTINE, FL 32080-3108
- **Practice address phone:** (904) 342-5965
- **Mailing address:** 1301 PLANTATION ISLAND DR S, SUITE 201-A, ST AUGUSTINE, FL 32080-3108
- **Mailing address phone:** (904) 342-5965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | ME88707 | FL | Yes |

## Other

- **Enumeration date:** 03/02/2016
- **Last updated:** 03/02/2016