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General NPI Number Information
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NPI Number | 1184874745
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN INTERNAL MEDICINE PA
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Dates
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Enumeration Date | 09/19/2008
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 3700 US HIGHWAY 1 S
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-7150
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Country | US
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Telephone | 904-794-2464
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 US HIGHWAY 1 S
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-7150
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Country | US
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Telephone | 904-794-2464
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GOAR DELAMERENS
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Credential | M.D.
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Telephone | 904-794-2464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | ME78888
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License Number State | FL
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