Southlake Family Practice Pa

LBN: Southlake Family Practice Pa
Southlake Family Practice Pa is an health care organization with primary practice located at 308 Kingsley Lake Dr Ste 802 , St Augustine FL 32092-3046. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Southlake Family Practice Pa can be contacted via phone (904) 827-0788, or through Kaluza, Malgorzata via phone (904) 827-0788.

Contact Information

Primary practice address
308 Kingsley Lake Dr Ste 802 St Augustine FL 32092-3046
Phone: (904) 827-0788
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kaluza, Malgorzata Doctor of Medicine (MD)
Phone: (904) 827-0788

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X ME79394 Florida

Profile Details

NPI number 1225247810
LBN Legal business name Southlake Family Practice Pa
DBA Doing business as
Authorized official Kaluza, Malgorzata Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 21st, 2007
Last updated Sep 29th, 2011 - about 13 years 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.

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