Organization
ST AUGUSTINE PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES L SOLANA JR. (PRESIDENT)
(904) 429-7071
Entity
Organization
Contact information
Practice address
1100 S PONCE DE LEON BLVD, SUITE 3-A, ST AUGUSTINE, FL 32084-6099
(904) 429-7071
Mailing address
1100 S PONCE DE LEON BLVD, SUITE 3-A, ST AUGUSTINE, FL 32084-6099
(904) 429-7071
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/20/2009
Last updated
10/20/2009
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