Provider Demographics
NPI:1497447163
Name:ESSENTIAL CARE GROUP, LLC
Entity Type:Organization
Organization Name:ESSENTIAL CARE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:VAUGHT
Authorized Official - Last Name:CONSIDINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-716-0508
Mailing Address - Street 1:120 PALENCIA VILLAGE DRIVE C-105
Mailing Address - Street 2:SUITE 318
Mailing Address - City:ST. AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32095
Mailing Address - Country:US
Mailing Address - Phone:904-716-0508
Mailing Address - Fax:
Practice Address - Street 1:1 SLEIMAN PARKWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-716-0508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty