Healthcare Provider Details

I. General information

NPI: 1568342624
Provider Name (Legal Business Name): AUBREY LEE KAMARIOTIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 SAINT SEBASTIAN WAY STE 104
AUGUSTA GA
30901-2652
US

IV. Provider business mailing address

518 MARTIN LN
AUGUSTA GA
30909-3406
US

V. Phone/Fax

Practice location:
  • Phone: 706-434-0130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13463
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number13463
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: