Healthcare Provider Details

I. General information

NPI: 1588091029
Provider Name (Legal Business Name): FM MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 A1A S
ST AUGUSTINE FL
32080-9731
US

IV. Provider business mailing address

3560 A1A S
ST AUGUSTINE FL
32080-9731
US

V. Phone/Fax

Practice location:
  • Phone: 904-584-2273
  • Fax: 904-429-9783
Mailing address:
  • Phone: 904-584-2273
  • Fax: 904-429-9783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME117337
License Number StateFL

VIII. Authorized Official

Name: DOROTHY MARIE AEPPLI
Title or Position: BILLING MANAGER
Credential:
Phone: 904-529-0141