Organization
ST AUGUSTINE ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLIN LEMAISTRE (OFFICER/AUTHORIZED OFFICIAL)
(214) 213-0732
Entity
Organization
Contact information
Practice address
40 GROOVER LOOP STE 100, ST AUGUSTINE, FL 32086-6569
(904) 824-6108
(904) 823-9613
Mailing address
40 GROOVER LOOP STE 100, SAINT AUGUSTINE, FL 32086-6569
(904) 824-6108
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079055900
—
FL
Enumeration date
03/31/2006
Last updated
03/24/2026
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