Organization
ST. JOHN'S PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LETICIA ROSARIO ABREA M.D. (PRESIDENT)
(904) 807-9112
Entity
Organization
Contact information
Practice address
161 HAMPTON POINT DRIVE STE 4, SAINT AUGUSTINE, FL 32092-3057
(904) 230-0624
(904) 230-7947
Mailing address
161 HAMPTON POINT DRIVE STE 4, SAINT AUGUSTINE, FL 32092-3057
(904) 230-0624
(904) 230-7947
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME90096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28637
BCBS
FL
Enumeration date
02/01/2007
Last updated
04/17/2008
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