Healthcare Provider Details

I. General information

NPI: 1477379741
Provider Name (Legal Business Name): ABIGAIL MURY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PLANTATION ISLAND DR S STE 202A
SAINT AUGUSTINE FL
32080-3111
US

IV. Provider business mailing address

2470 OLEANDER ST
ST AUGUSTINE FL
32080-5800
US

V. Phone/Fax

Practice location:
  • Phone: 561-903-4676
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL MURY
Title or Position: OWNER
Credential: LCSW
Phone: 239-634-9548