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Contact Information

12TH AVENUE HEALTHCARE, INC
1101 OFFICE WOODS DR
PENSACOLA, FL32504-5937
 Phone: 850-776-7872
 Fax: 850-474-9060
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for 12TH AVENUE HEALTHCARE INC · (Female)

NPI Number 1003528258
Status Active
Credentials
Entity Individual
Enumeration date 12/20/2022
Last updated 12/20/2022 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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