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PANACEA ALLIANCE CORP.
NPI 1326298803
Family Medicine in St Augustine, FL

Active since September 22, 2008
1750 TREE BLVD, STE 5, ST AUGUSTINE, FL 32084(904) 342-0672(904) 342-0673 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 16, 2024, Sep 5, 2023, Aug 5, 2020 (3 updates tracked since 2020).

About Panacea Alliance Corp. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PANACEA ALLIANCE CORP. (NPI 1326298803) is a healthcare organization registered as a family medicine in St Augustine, Florida and active in the NPI registry since September 2008. The organization lists Eneida Gomez, Owner, as its authorized official.

NPPES Registry Identity

NPI1326298803
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePANACEA ALLIANCE CORP.
Location Address1750 TREE BLVD, STE 5St Augustine, FL 32084-5715
Mailing Address1750 Tree Blvd Ste 5St Augustine, FL 32084-5719 · (904) 342-0672
Phone(904) 342-0672
Fax(904) 342-0673
Organization SubpartNo
Authorized OfficialEneida GomezOwner · (904) 342-0672
Enumeration DateSeptember 22, 2008
Last NPPES UpdateApril 16, 20243 updates tracked since enumeration
NPPES CertifiedApril 16, 2024
✔ NPI 1326298803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License ME83444 (FL)
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X · License ME 83444 (FL)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
1750 TREE BLVD, St Augustine, FL 32084
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Panacea Alliance Corp. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Panacea Alliance Corp., which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Angelia Fuller, ARNP
Nurse Practitioner
NPI 1366866204
1750 TREE BLVD STE 5
St Augustine, FL 32084
(904) 342-0672
✔ PECOS✔ Accepts MedicareSame address
Eneida Gomez, MD
Psychiatry
NPI 1366431835
1750 TREE BLVD STE 5
St Augustine, FL 32084
(904) 342-0672
✔ PECOSSame address
Nicole Trevor, APRN, PMHNP-BC
Nurse Practitioner
NPI 1780484196
1750 TREE BLVD
Saint Augustine, FL 32084
(904) 342-0672
✔ PECOS✔ Accepts MedicareSame address
Rajesh Persaud, M.D.
General Practice
NPI 1023384179
16 SAINT JOHNS MEDICAL PARK DR
Saint Augustine, FL 32086
(904) 794-5411
✔ PECOS✔ Accepts Medicare2.1 mi
Jorge De La Rotta Soto, APRN
Nurse Practitioner
NPI 1245791078
90 FORT WADE RD STE 100
Ponte Vedra, FL 32081
(904) 377-2675
✔ PECOS✔ Accepts Medicare18 mi
Daniel Weinberg, MD
Psychiatry
NPI 1124291885
1542 KINGSLEY AVE STE 136-137
Orange Park, FL 32073
(239) 690-6906
✔ PECOS✔ Accepts Medicare31 mi
Mayralis Enamorado, MD
Internal Medicine
NPI 1457107484
1100 CESERY BLVD
Jacksonville, FL 32211
(904) 551-5884
✔ PECOS✔ Accepts Medicare36 mi
Wesley Roach
Psychiatry
NPI 1235831983
720 W OAK ST STE 201
Kissimmee, FL 34741
(407) 518-2703
✔ PECOS108 mi
Concepcion Barreto, M.D.
General Practice
NPI 1932236601
201 RUBY AVE STE A
Kissimmee, FL 34741
(407) 933-1847
✔ PECOS✔ Accepts Medicare109 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Panacea Alliance Corp.'s NPI number?

The NPI number for Panacea Alliance Corp. is 1326298803. It was assigned to this organization in the NPPES registry on September 22, 2008.

Where is Panacea Alliance Corp. located?

Panacea Alliance Corp. is located at 1750 Tree Blvd Ste 5, St Augustine, FL 32084. The listed phone number is (904) 342-0672.

What is Panacea Alliance Corp.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Panacea Alliance Corp. enrolled in Medicare?

Yes. Panacea Alliance Corp. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Panacea Alliance Corp.?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 4 Medicare specialties reassign their Medicare billing to Panacea Alliance Corp.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Psychiatry (3) and General Practice (2). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Panacea Alliance Corp. was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.