Organization
ANASTASIA PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONALI MANIKAL MD (DOCTOR)
(904) 819-9925
Entity
Organization
Contact information
Practice address
100 WHETSTONE PL, SUITE 205, ST AUGUSTINE, FL 32086-5774
(904) 819-9925
(904) 819-9926
Mailing address
100 WHETSTONE PL, SUITE 205, ST AUGUSTINE, FL 32086-5774
(904) 819-9925
(904) 819-9926
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0081118
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003482600
—
FL
05
—
259789600
—
FL
Enumeration date
04/10/2012
Last updated
04/30/2013
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