Individual
KEITH MYRON JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2460 OLD MOULTRIE RD STE 4, ST AUGUSTINE, FL 32086-4198
(904) 563-1482
Mailing address
2460 OLD MOULTRIE RD STE 4, ST AUGUSTINE, FL 32086-4198
(904) 563-1482
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME 75770
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255358900
—
FL
01
—
272323
AVMED
FL
01
—
44678
BCBS
FL
01
—
7174040
AETNA
FL
01
—
G78663
UPIN
FL
Enumeration date
06/14/2005
Last updated
03/07/2023
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