Anastasia Medical Group, Llc

LBN: Anastasia Medical Group, Llc
Anastasia Medical Group, Llc is an health care organization with primary practice located at 1301 Plantation Island Drive Suite 203A, St Augustine FL 32080. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, Podiatric Medicine & Surgery Service Providers / Podiatrist. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Anastasia Medical Group, Llc can be contacted via phone (904) 461-0821, or through Neerukonda, Suhas P via phone (904) 461-0343.

Contact Information

Primary practice address
1301 Plantation Island Drive Suite 203A St Augustine FL 32080
Phone: (904) 461-0821
Fax: (904) 461-0823
Website:
Map and Directions
Authorized official contact:
Name: Neerukonda, Suhas P Doctor of Medicine (MD)
Phone: (904) 461-0343

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X

Profile Details

NPI number 1710940648
LBN Legal business name Anastasia Medical Group, Llc
DBA Doing business as
Authorized official Neerukonda, Suhas P Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2006
Last updated Jan 15th, 2024 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1710940648 NPPES
Florida Other 99767 BCBS
Florida MEDICAID 277020200 BCBS

Popular Providers