Provider Demographics
NPI:1184874745
Name:ASSOCIATES IN INTERNAL MEDICINE PA
Entity type:Organization
Organization Name:ASSOCIATES IN INTERNAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GOAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAMERENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-794-2464
Mailing Address - Street 1:3700 US HIGHWAY 1 S
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-7150
Mailing Address - Country:US
Mailing Address - Phone:904-794-2464
Mailing Address - Fax:
Practice Address - Street 1:3700 US HIGHWAY 1 S
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-7150
Practice Address - Country:US
Practice Address - Phone:904-794-2464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78888173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3382YMedicare UPIN