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Contact Information

ABC PEDIATRICS OF OKALOOSA
182 E. REDSTONE AVE
SUITE B
CRESTVIEW, FL32539
 Phone: 850-689-0900
 Fax: 850-689-0912
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for ABC PEDIATRICS OF OKALOOSA

NPI Number 1326418336
LBN Legal business name ABC PEDIATRICS OF OKALOOSA
Authorized official DENISE MITCHELL - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/02/2015
Last updated 10/02/2015 - About 11 years ago
Identifiers
FL License # ME70831
FL Medicaid 250009400
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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