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:
Authorized official contact:
Name: Neerukonda, Suhas P Doctor of Medicine (MD)
Phone: (904) 461-0343
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710940648 | NPPES |
| Florida | Other | 99767 | BCBS |
| Florida | MEDICAID | 277020200 | BCBS |
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