Healthcare Provider Details

I. General information

NPI: 1407721152
Provider Name (Legal Business Name): NATASHA PAYTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD STE 3002
ST AUGUSTINE FL
32086-3703
US

IV. Provider business mailing address

121 WILLOW OAK WAY
PALM COAST FL
32137-6930
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-1500
  • Fax:
Mailing address:
  • Phone: 306-260-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME177334
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: