| Kolbe Clinic Of Florida, Llc | |
|
8734 Ortega Park Dr Navarre FL 32566-4139 | |
| (850) 904-2277 | |
| (205) 618-9706 |
| Full Name | Kolbe Clinic Of Florida, Llc |
|---|---|
| Speciality | Counselor |
| Location | 8734 Ortega Park Dr, Navarre, Florida |
| Authorized Official Name and Position | William Carl Wainscott (CEO) |
| Authorized Official Contact | 8509042277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kolbe Clinic Of Florida, Llc 1830 Montclair Rd Ste A Irondale AL 35210-2645 Ph: (850) 904-2277 | Kolbe Clinic Of Florida, Llc 8734 Ortega Park Dr Navarre FL 32566-4139 Ph: (850) 904-2277 |
| NPI Number | 1952964132 |
|---|---|
| Provider Enumeration Date | 04/15/2019 |
| Last Update Date | 04/15/2019 |
| Medicare PECOS PAC ID | 1759624133 |
|---|---|
| Medicare Enrollment ID | O20190529000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952964132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| Provider Name | Robert A Ruth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912926437 PECOS PAC ID: 5890788046 Enrollment ID: I20050831000845 |
| Provider Name | Laurie A Gerhard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962440461 PECOS PAC ID: 8426073909 Enrollment ID: I20051013000567 |
| Provider Name | Cherri Jennewein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932413994 PECOS PAC ID: 8628395522 Enrollment ID: I20150401001932 |
| Provider Name | Diane C Haskill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770898033 PECOS PAC ID: 9931497633 Enrollment ID: I20161012002527 |
| Provider Name | Frankie J Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477848026 PECOS PAC ID: 8325321193 Enrollment ID: I20170118002234 |
| Provider Name | Samantha M Ervin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659962363 PECOS PAC ID: 5294142519 Enrollment ID: I20210401001066 |
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