Organization
FIRST COAST GASTROENTEROLOGY
Active
Other names
Ben C Pineau MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENOIT C PINEAU MD (AUTHORIZED OFFICIAL)
(904) 829-9557
Entity
Organization
Contact information
Practice address
100 WHETSTONE PL, SUITE 105, ST AUGUSTINE, FL 32086-5773
(904) 829-9557
(904) 829-9125
Mailing address
100 WHETSTONE PL, SUITE 105, ST AUGUSTINE, FL 32086-5773
(904) 829-9557
(904) 829-9125
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME90376
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269931100
—
FL
01
—
44069
BCBS
FL
01
—
DC0902
MEDICARE RR - GROUP #
—
01
—
P00147263
MEDICARE RR
—
Enumeration date
07/29/2005
Last updated
10/09/2008
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