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General NPI Number Information
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NPI Number | 1316807175
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Entity Type | Organization
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Legal Business Name | ST. AUGUSTINE DIRECT PRIMARY CARE, LLC
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Dates
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Enumeration Date | 11/14/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 2200 N PONCE DE LEON BLVD STE 1
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-2650
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Country | US
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Telephone | 904-657-5736
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Fax | 904-877-5276
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Provider Business Mailing Address
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Address Line | 2200 N PONCE DE LEON BLVD STE 1
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-2650
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Country | US
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Telephone | 904-657-5736
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Fax | 904-877-5276
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Authorized Official
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Title or Position | OWNER, APRN
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Name | MS. MARGARET E. CORRIGAN
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Credential | APRN
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Telephone | 904-962-7815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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