SOUTHLAKE FAMILY PRACTICE PA
Ambulatory Health at Kingsley Lake Dr, Saint Augustine, FL

License number
Florida ME79394
Category
Ambulatory Health
Type
Primary Care
Owner
Name: MALGORZATA KALUZA MD
Title: MEDICAL DIRECTOR
Phone: (904) 827-0788
Address
Address
308 Kingsley Lake Dr STE 802, Saint Augustine, FL 32092
National Provider ID: 1225247810
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Southlake Family Practice

Saint Augustine, FL  -  Jacksonville, FL

Industry:
Medical Doctor's Office
Doing business as:
Southlake Family Practice, PA
Registration:
May 26, 2004
Phone:
(904) 827-0788 (Phone)
Addresses:
308 Kingsley Lk Dr, Saint Augustine, FL 32092
8730 Hunters Crk Dr S, Jacksonville, FL 32256
State ID:
P04000083538
Business type:
Domestic for Profit Corporation
Treasurer, Secretarys:
Malgorzata Kaluza (Family Practitioner, Medical Director, Medical Doctor, Principal, President, Vice President),Judith Whitman (Physician Assistant),Peter Kaluza (Office Manager),...
Categories:
Family & General Practice Physicians & Surgeons, Physicians & Surgeons
Specialties:
Family Practice, General Practice

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