OrganizationActive
Ancient City Pediatrics
NPI 1053598292 · Pediatrics Physician · Saint Augustine, FL
Provider details
- NPI number
- 1053598292
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Adrienne Mccoy, Office Manager(904) 461-1560
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1301 Plantation Island Dr S Ste 104
Saint Augustine, FL 32080-3108
Phone: (904) 461-1560
Fax: (904) 461-4304
Approximate (ZIP-level) locationGet directions
Mailing address
1301 Plantation Island Dr S Ste 104
Saint Augustine, FL 32080-3108
Other names (DBA / former)
- Doing business as
- Dba Sunshine Pediatrics of St Augustine
Registry dates
- Enumerated
- 2008-01-30
- Last updated
- 2025-09-02
- Certified
- 2024-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.