Organization
ST. AUGUSTINE PEDIATRIC ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SOBERANO MD (OWNER)
(904) 824-5437
Entity
Organization
Contact information
Practice address
1301 PLANTATION ISLAND DR S, SUITE 106B, ST AUGUSTINE, FL 32080-3108
(904) 461-8906
(904) 461-7575
Mailing address
1301 PLANTATION ISLAND DR S, SUITE 106B, ST AUGUSTINE, FL 32080-3108
(904) 461-8906
(904) 461-7575
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME78696
FL
Other
Enumeration date
05/18/2007
Last updated
08/17/2015
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