Unknown Individual – Surgery Physician, NPI 1558460667
Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
St Augustine Post Office, 34, Main Street, St. Augustine, Knox County, Illinois, 61474, United States
ST AUGUSTINE, FL 320853123
Phone: (904) 824-4990
Fax: (904) 824-2226
Type: Mailing
201, Health Park Boulevard, St. Augustine South, Saint Johns County, Florida, 32086, United States
SUITE 107
ST AUGUSTINE, FL 320865796
Phone: (904) 819-0101
Fax: (904) 825-4759
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
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)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32085)
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