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Contact Information

EARLY INTERVENTION SPECIALISTS OF NORTHWEST FLORIDA, LLC
5170 12TH AVE
MALONE, FL32445-3426
 Phone: 850-209-5880
 Fax: 866-521-4620
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Early Intervention Provider Agency

252Y00000X
Indicates primary specialty

NPI Profile & details for EARLY INTERVENTION SPECIALISTS OF NORTHWEST FLORIDA, LLC

NPI # 1063753572
LBN Legal business name EARLY INTERVENTION SPECIALISTS OF NORTHWEST FLORIDA, LLC
Authorized official MARCIA THOMPSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/07/2013
Last updated 03/07/2013 - About 13 years ago
Identifiers
FL License # RN3076242
FL Medicaid 810941900
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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