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General NPI Number Information
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NPI Number | 1821165101
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Entity Type | Organization
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Legal Business Name | ST. JOHNS COUNTY SCHOOL DISTRICT
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 1 CHRISTOPHER ST
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-4056
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Country | US
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Telephone | 904-819-7149
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Fax | 904-819-7145
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Provider Business Mailing Address
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Address Line | 40 ORANGE ST
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-3633
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Country | US
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Telephone | 904-547-7662
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Fax |
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Authorized Official
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Title or Position | MEDICAID SPECIALIST
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Name | AMBER FICKETT
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Credential |
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Telephone | 904-547-7662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | FL
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