ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA – Pediatrics Physician, NPI 1174518179

ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA is a healthcare provider. based in St augustine, Florida. specializing in Pediatrics Physician. The organization holds a License No. ME73431 (FL). The NPI Number for ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA is 1174518179

Main info

Organization
Name
ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA
NPI
1174518179
Phone
(904) 827-0032
Address
67 S DIXIE HWY
Authorized Official
VANDANA Y BHIDE MD MD
Enumeration Date
15 September 2005
Last Update Date
10 November 2010
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA

  • South Dixie Highway, West Augustine, Saint Augustine, Saint Johns County, Florida, 32084, United States

    ST AUGUSTINE, FL 320840317

    Phone: (904) 827-0032

    Fax: (904) 827-0985

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32084)

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Reviews

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Frequently asked questions

How do payers reference ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA?
For ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA, use NPI 1174518179 as the unique 10-digit identifier.
Would ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA appear as active to a payer?
You can treat ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA?
At a glance, ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA is tied to Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Is ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA located near St Augustine?
ST AUGUSTINE ADULT & PEDIATRIC MEDICINE PA currently maps to St Augustine, Florida in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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