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Contact Information

NORTHWEST FLORIDA ENT PA
310 RACETRACK RD NW STE 100
FORT WALTON BEACH, FL32547-1553
 Phone: 850-889-4550
 Fax: 850-889-4549
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Otolaryngic Allergy

207YX0602X 04 Physician/Otolaryngology
 

Sleep Medicine

207YS0012X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for NORTHWEST FLORIDA ENT PA · (Female)

NPI # 1821466491
Status Active
Credentials
Entity Individual
Enumeration date 09/12/2015
Last updated 04/13/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME96773
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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