COMMUNITY CARE PEDIATRICS PA
NPI 1639437569
Clinic/Center - Primary Care in Saint Augustine, FL

Q: What is Community Care Pediatrics PA's NPI number?

The NPI number for Community Care Pediatrics PA is 1639437569. It was assigned to this organization in the NPPES registry on April 28, 2012.

Q: What is Community Care Pediatrics PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since April 28, 2012

3670 US 1 SOUTH STE 300 B, SAINT AUGUSTINE, FL 32086(904) 479-9501(904) 217-0524 Get Directions Write a Review

NPPES record last updated: February 14, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Community Care Pediatrics Pa NPPES

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

COMMUNITY CARE PEDIATRICS PA (NPI 1639437569) is a healthcare organization registered as a primary care in Saint Augustine, Florida and active in the NPI registry since April 2012. The organization maintains a secondary practice location in Interlachen and lists Luis Anderson, Md/president/owner, as its authorized official.

NPPES Registry Identity

NPI1639437569

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameCOMMUNITY CARE PEDIATRICS PA

Location Address3670 US 1 SOUTH STE 300 BSaint Augustine, FL 32086

Mailing Address3670 Us 1 South Ste 300 BSaint Augustine, FL 32086 · (904) 479-9501 · Fax (904) 217-0524

Phone(904) 479-9501

Fax(904) 217-0524

Organization SubpartNo

Authorized OfficialLuis AndersonMd/president/owner · (904) 479-9501

Enumeration DateApril 28, 2012

Last NPPES UpdateFebruary 14, 2020

✔ NPI 1639437569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

Also ListedPediatricsTaxonomy 208000000X

3670 US 1 SOUTH STE 300 B, Saint Augustine, FL 32086

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Secondary Practice Location 1

Location 1885 State Road 20Interlachen, FL 32148-2430 · Phone (386) 643-0400 · Fax (386) 350-0398

Other Identifiers 1

Medicaid269304600FL

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

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 Community Care Pediatrics PA's NPI number?

The NPI number for Community Care Pediatrics PA is 1639437569. It was assigned to this organization in the NPPES registry on April 28, 2012.

Where is Community Care Pediatrics PA located?

Community Care Pediatrics PA is located at 3670 Us 1 South Ste 300 B, Saint Augustine, FL 32086. The listed phone number is (904) 479-9501.

What is Community Care Pediatrics PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Community Care Pediatrics PA was last updated on February 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.