PHYSICIAN ASSOCIATES GROUP, INC. (NPI# 1730549817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730549817 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN ASSOCIATES GROUP, INC. |
| Practice Address |
1301 Plantation Island Dr S Suite 201-a St Augustine FL 32080-3108 |
| Practice Telephone | 9043425965 |
| Mailing Telephone | 9043425965 |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2016-03-02 |
| Authorized Official Name | JEREMY MIRABILE (MEDICAL DOCTOR) |
| Authorized Official Telephone | 9043425965 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
ME88707 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
1301 PLANTATION ISLAND DR S SUITE 201-A |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32080-3108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013900893 | Melchor G Barros | Family Medicine | 1301 Plantation Island Dr S, 102-b, St Augustine, FL 32080-3108 | 2005-08-26 |
| 1316487218 | Jesse Fazzingo | Nurse Practitioner | 1301 Plantation Island Dr S, Suite 302a, St Augustine, FL 32080-3108 | 2017-02-27 |
| 1407390529 | Nakisha Marie Carrasquillo-richardson | Psychologist | 1301 Plantation Island Dr S, Ste. 201 A, St Augustine, FL 32080-3108 | 2016-12-08 |
| 1841733268 | Ronda Jo Jarvis | Social Worker | 1301 Plantation Island Dr S, Suite 201a, St Augustine, FL 32080-3108 | 2016-12-03 |
| 1528510047 | Michelle Murray Craun | Marriage & Family Therapist | 1301 Plantation Island Dr S, 201b, St Augustine, FL 32080-3108 | 2016-11-01 |
| 1770942260 | Northeast Florida Endocrine and Diabetes Associates, Pa | Specialist | 1301 Plantation Island Dr S, Suite 203a, St Augustine, FL 32080-3108 | 2016-02-12 |
| 1518339761 | Cindy O Chaconas | Physical Therapist | 1301 Plantation Island Dr S, Suite 203a, St Augustine, FL 32080-3111 | 2015-10-28 |
| 1033528872 | Michael Hines | Hearing Instrument Specialist | 1301 Plantation Island Dr S, Suite 401b, St Augustine, FL 32080-3108 | 2014-08-06 |
| 1790086429 | Harbour Island Pediatrics | Pediatrics | 1301 Plantation Island Dr S, Suite 106-b, St Augustine, FL 32080-3108 | 2010-11-11 |
| 1962719492 | Alejandro Navarro | Physician Assistant | 1301 Plantation Island Dr S, Ste 140, St Augustine, FL 32080-3108 | 2010-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659991925 | Healthy Minds Psychological Services, LLC | Psychologist | 825 Kalli Creek Lane, Saint Augustine, FL 32080 | 2020-04-16 |
| 1215456629 | Sidney Leigh Thomas | Specialist/Technologist | 976 Saltwater Circle, St. Augustine, FL 32080 | 2017-09-18 |
| 1285164855 | Mary Patricia Pichan | Speech-Language Pathologist | 2870 Peachtree Rd. #293, Atlanta, GA 32080 | 2017-06-15 |
| 1962947325 | Joseph Costine | Behavior Technician | 205 7th St. Apt.b, St. Augustine, FL 32080 | 2016-12-21 |
| 1437605177 | Jenifer Long | Social Worker | 1301 Plantation Island Drive South, Suite 201a, St Augustine, FL 32080 | 2016-09-01 |
| 1205207420 | Ana Greenberger | Nurse Practitioner | 1301 Plantation Island Dr S Ste 401, Saint Augustine, FL 32080 | 2015-10-14 |
| 1598037202 | Dana Elizabeth Jones | Occupational Therapist | 3 Hannah Cole Dr., St. Augustine, FL 32080 | 2012-01-27 |
| 1205159423 | Chesapeake Hyperbaric Lc | Clinic/Center | 129 Seagrove Main Street, Unit 202, St. Augustine, FL 32080 | 2010-03-02 |
| 1306176037 | Barros Family Healthcare Pa | Clinic/Center | 1301 Plantation Island Dr. South 102b, St. Augustine, FL 32080 | 2009-12-31 |
| 1609041995 | Tommy D Murphy | Specialist | 403 Anastasia Blvd., St. Augustine, FL 32080 | 2008-04-28 |
| Find all providers in zip 32080 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313472 | Athena Medical LLC | Psychiatry & Neurology | 2001 Hollywood Blvd Ste 207, Hollywood, FL 33020-4536 | 2020-07-21 |
| 1720612013 | New Perspective Mental Health LLC | Psychiatry & Neurology | 6141 Sw 72nd St Ste 402, South Miami, FL 33143-5026 | 2020-02-26 |
| 1972165231 | Blossoming Wellbeing Corp. | Psychiatry & Neurology | 6622 32nd Way S, St Petersburg, FL 33712-5408 | 2019-07-07 |
| 1104391648 | Summit Detox | Psychiatry & Neurology | 3330 S. Federal Highway, 3rd Floor, Boynton Beach, FL 33435 | 2018-10-11 |
| 1679057814 | United Health and Wellness Group, Inc. | Psychiatry & Neurology | 201 N Federal Hwy Ste 105, Deerfield Beach, FL 33441-3621 | 2018-09-24 |
| 1467934224 | Arh Medical Group LLC | Psychiatry & Neurology | 631 Us Highway 1 Ste 409, North Palm Beach, FL 33408-4621 | 2018-08-29 |
| 1255879060 | Round Care, Inc | Psychiatry & Neurology | 300 W Sunrise Blvd Ste 3, Ft Lauderdale, FL 33311-6200 | 2017-02-01 |
| 1154766541 | Paul Roberts | Psychiatry & Neurology | 8529 Southpark Cir, Suite 270, Orlando, FL 32819-9029 | 2013-04-30 |
| 1386910172 | Siddharth Singh Arora | Psychiatry & Neurology | 1811 S Orlando Ave Ste A, Cocoa Beach, FL 32931-2340 | 2012-03-27 |
| 1194010694 | Laurie Ann Solomon | Psychiatry & Neurology | 100 Newell Dr # L4100, Gainesville, FL 32611-1912 | 2011-06-13 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32080 |
Please comment or provide details below to improve the information on PHYSICIAN ASSOCIATES GROUP, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.