Port St. Joe Office is a
Optometrist based in Port St Joe, Florida. Port St. Joe Office is licensed to practice in * (Not Available) (license number ) and their current practice location is
528b 5th St, Port St Joe, Florida. It can be reached at their office (for appointments etc.) via phone at
(850) 227-7266.
NPI number for Port St. Joe Office is 1912002395 and their current mailing address is 2500 Martin Luther King Jr. Blvd, Panama City, Florida. Port St. Joe Office
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1912002395.
Healthcare Provider's Profile
| Full Name | Port St. Joe Office |
|---|
| Type | Facility |
|---|
| Speciality | Optometrist |
|---|
| Location | 528b 5th St, Port St Joe, Florida |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1912002395
- Provider Enumeration Date: 09/13/2006
- Last Update Date: 04/20/2023
Medical Identifiers
Medical identifiers for Port St. Joe Office such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912002395 | NPI | - | NPPES |
| 1740213529 | Other | FL | GROUP NPI |
| CG6943 | Other | FL | RR MEDICARE |
| 257952901 | Medicaid | FL | |
| 45154C | Other | FL | BLUE CROSS & BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 152WC0802X | Optometrist - Corneal And Contact Management | (* (Not Available)) | Secondary |
| 152WL0500X | Optometrist - Low Vision Rehabilitation | (* (Not Available)) | Secondary |
| 152WP0200X | Optometrist - Pediatrics | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Port St. Joe Office is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Port St. Joe Office
2500 Martin Luther King Jr. Blvd,
Panama City, FL 32405-4412
Ph: (850) 784-3937 | Port St. Joe Office
528b 5th St,
Port St Joe, FL 32456-1754
Ph: (850) 227-7266 |
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