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

Institute of Internal Medicine P A

Organization Internal Medicine Physician · NPI 1457523003

Institute of Internal Medicine P A is an Internal Medicine Physician in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2008.

Licensed in
FL
In the registry since
2008
Specialties on file
2

Practice location Address checks out

1301 Plantation Island Dr S Ste 402B
St Augustine, FL 32080-3108
Phone: (904) 460-0707
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence ME76599 (FL)
Addiction Medicine (Internal Medicine) Physician Taxonomy 207RA0401X · Licence ME76599 (FL)

Record details

NPI number1457523003
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carmen Vivero — President · (904) 460-0707
NPI enumeratedMarch 24, 2008
Last updated in NPPESSeptember 15, 2011
Mailing address1301 Plantation Island Dr S, Ste 402-B, St Augustine, FL 32080-3108

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