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General NPI Number Information
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NPI Number | 1346202488
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTH CARE OF ST AUGUSTINE PA
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 101 WHITEHALL DR STE 108
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5268
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Country | US
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Telephone | 904-797-4440
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Fax | 904-797-4997
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Provider Business Mailing Address
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Address Line | 101 WHITEHALL DR STE 108
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5268
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Country | US
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Telephone | 904-797-4440
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Fax | 904-797-4997
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ROBERT E DUPREE JR
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Credential | MD
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Telephone | 904-797-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | FLME0055260
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License Number State | FL
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