OrganizationActive
Physician Associates Group, Inc.
NPI 1730549817 · Addiction Medicine (Psychiatry & Neurology) Physician · St Augustine, FL
Provider details
- NPI number
- 1730549817
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeremy Mirabile, Medical Doctor(904) 342-5965
- License
- ME88707 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1301 Plantation Island Dr S
Suite 201-A
St Augustine, FL 32080-3108
Phone: (904) 342-5965
Street-level locationGet directions
Mailing address
1301 Plantation Island Dr S
St Augustine, FL 32080-3108
Registry dates
- Enumerated
- 2016-03-02
- Last updated
- 2016-03-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.