Organization
EMERGENCY PHYSICIANS OF ST. JOHNS COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY EDELBERG MD (PRESIDENT/OWNER)
(888) 680-6067
Entity
Organization
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5784
(904) 826-4700
Mailing address
PO BOX 863639, ORLANDO, FL 32886-3639
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34811
BCBS
FL
01
—
CI9014
RR MCR GROUP
FL
Enumeration date
09/15/2005
Last updated
08/22/2020
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