National Provider Identifier Database

DESTIN SURGERY CLINIC PA
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

DESTIN SURGERY CLINIC, P.A.
415 MOUNTAIN DRIVE
SUITE # 6
DESTIN, FL32541
Phone: 850-837-8831
Fax: 850-837-9137
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for DESTIN SURGERY CLINIC, P.A.

NPI Number 1457661605
Legal business name
LBN
DESTIN SURGERY CLINIC, P.A.
Authorized official JAMES MOODY - (PHYSICIAN/OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/20/2010
Last updated 10/20/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: ME0052108

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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