Organization
ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANDANA Y BHIDE MD (MD)
(904) 827-0032
Entity
Organization
Contact information
Practice address
67 S DIXIE HWY, ST AUGUSTINE, FL 32084-0317
(904) 827-0032
(904) 827-0985
Mailing address
67 S DIXIE HWY, ST AUGUSTINE, FL 32084-0317
(904) 827-0032
(904) 827-0985
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME73431
FL
208000000X
Pediatrics Physician
Primary
ME73431
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110169538
RR MC
—
05
—
252533000
—
FL
01
—
41496
BCBS
—
Enumeration date
09/15/2005
Last updated
11/10/2010
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