| Emerald Coast Center For Neurological Disorders | |
|
1110 Airport Blvd Suite B Pensacola FL 32504 | |
| (850) 438-1136 | |
| (850) 438-1148 |
| Full Name | Emerald Coast Center For Neurological Disorders |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1110 Airport Blvd, Pensacola, Florida |
| Authorized Official Name and Position | Daniel Ross (PARTNER) |
| Authorized Official Contact | 8504381136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Center For Neurological Disorders 1110 Airport Blvd Suite B Pensacola FL 32504 Ph: (850) 438-1136 | Emerald Coast Center For Neurological Disorders 1110 Airport Blvd Suite B Pensacola FL 32504 Ph: (850) 438-1136 |
| NPI Number | 1750315701 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 08/17/2020 |
| Certification Date | 08/17/2020 |
| Medicare PECOS PAC ID | 2062417215 |
|---|---|
| Medicare Enrollment ID | O20060922000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750315701 | NPI | - | NPPES |
| 275377400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Daniel E Ross |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528037256 PECOS PAC ID: 9234134487 Enrollment ID: I20060922000184 |
| Provider Name | David M Bear |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689643645 PECOS PAC ID: 3779588926 Enrollment ID: I20060922000187 |
| Provider Name | Henry O Porter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811989346 PECOS PAC ID: 9032242748 Enrollment ID: I20100802000748 |
| Provider Name | Michelle Santiago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982103552 PECOS PAC ID: 1658634746 Enrollment ID: I20180425000675 |
| Provider Name | Laura L Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245894658 PECOS PAC ID: 8628301660 Enrollment ID: I20190606002462 |
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