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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

NPI # 1821466491
LBN Legal business name NORTHWEST FLORIDA ENT PA
Authorized official JASON BOOLE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/12/2015
Last updated 04/13/2019 - About 7 years ago
Identifiers
FL License # ME96773
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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