|
| |
|
4400 E Highway 20 Ste 203 Niceville FL 32578-7700 | |
| (850) 897-1824 | |
| (850) 897-1827 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 4400 E Highway 20 Ste 203, Niceville, Florida |
| Authorized Official Name and Position | Joseph Rapa (BUSINESS DIRECTOR) |
| Authorized Official Contact | 8502262895 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4400 E Highway 20 Ste 203 Niceville FL 32578-7700 Ph: (850) 897-1824 | 4400 E Highway 20 Ste 203 Niceville FL 32578-7700 Ph: (850) 897-1824 |
| NPI Number | 1508054594 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 01/02/2025 |
| Medicare PECOS PAC ID | 2769476324 |
|---|---|
| Medicare Enrollment ID | O20040414001331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508054594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0029230 (Florida) | Primary |
| Provider Name | Allan L Fedosky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366458408 PECOS PAC ID: 6406743046 Enrollment ID: I20040301000098 |
| Provider Name | Jennifer Lynn Lay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851379101 PECOS PAC ID: 8921439951 Enrollment ID: I20200507001358 |
| Provider Name | Christi Rochelle Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881383578 PECOS PAC ID: 4880055508 Enrollment ID: I20230727003486 |
Rose Family Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4400 E Highway 20 Ste 207, Niceville, FL 32578 Phone: 850-806-2440 | |
Emerald Coast Health Institute, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4566 E Highway 20, Niceville, FL 32578 Phone: 850-279-6949 Fax: 850-279-6957 | |
Pat T. Tidwell Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4554 Highway 20 East, Niceville, FL 32578 Phone: 850-678-6735 Fax: 850-678-8078 | |
Mark E. Schroeder M.d.pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 College Blvd W, Suite C, Niceville, FL 32578 Phone: 850-678-3994 | |
Julie Staats Do Family Medicine Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2600 Partin Dr N Ste 120, Niceville, FL 32578 Phone: 850-279-3040 Fax: 850-279-3312 | |
Select Physical Therapy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 554 Twin Cities Blvd Ste A, Niceville, FL 32578 Phone: 850-729-3325 |