Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Community Care Pediatrics PA

Organization Pediatrics Physician · NPI 1639437569

Community Care Pediatrics PA is a Pediatrics Physician in Saint Augustine, Florida. Works from 2 locations. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3670 US 1 S Ste 300 B
Saint Augustine, FL 32086
Phone: (904) 479-9501
Fax: (904) 217-0524
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 885 State Road 20, Interlachen, FL 32148-2430 — (386) 643-0400

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Pediatrics Physician Taxonomy 208000000X

Record details

NPI number1639437569
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Luis Anderson — Md/President/Owner · (904) 479-9501
NPI enumeratedApril 28, 2012
Last updated in NPPESFebruary 14, 2020
Certification dateFebruary 14, 2020
Mailing address3670 Us 1 South Ste 300 B, Saint Augustine, FL 32086

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