Healthcare Provider Details

I. General information

NPI: 1003794751
Provider Name (Legal Business Name): FIFE INTEGRATIVE HEALTH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 N 6TH ST STE 5138
ST AUGUSTINE FL
32084-1920
US

IV. Provider business mailing address

2800 N 6TH ST STE 5138
ST AUGUSTINE FL
32084-1920
US

V. Phone/Fax

Practice location:
  • Phone: 904-944-6196
  • Fax:
Mailing address:
  • Phone: 904-944-6196
  • Fax: 904-341-5481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. TONI FIFE
Title or Position: CEO
Credential: DNP
Phone: 540-771-4202