Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARJORIE DINA BACON, MD
Active Sole ProprietorDR. MARJORIE DINA BACON, MD is a Family Medicine healthcare provider located in ST AUGUSTINE, Florida. NPI 1174145304 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · ST AUGUSTINE, FL
Registration Details
- NPI Number
- 1174145304
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 11, 2020 (6.0765701107862 yrs)
- Last Updated
- Jul 16, 2025
- Licenses
-
338808 (LA)1908R77909 (AZ)ME158234 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
442 PASEO REYES DRST AUGUSTINE, FL, 320958558Browse FL providers · Browse ZIP 32095
- Phone
- 9045441738
- Fax
- 9048728863
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in ST AUGUSTINE, FL
| Name | Credential | NPI |
|---|---|---|
| DR. MARY ELIZABETH RAY | D.O. | 1306846795 |
| MICHAEL CLORE SANDERS | MD | 1003817040 |
| DR. MELCHOR G BARROS | MD | 1013900893 |
| KENNETH R HITZ | MD | 1326022195 |
| DR. JULIE DEAUN GRAVES | MD | 1093794265 |
| BRIAN D RAYMAKER | MD | 1184696221 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.