| Emerald Coast Family Medicine Inc | |
|
143 S John Sims Pkwy Valparaiso FL 32580-1271 | |
| (850) 729-3300 | |
| (850) 729-3100 |
| Full Name | Emerald Coast Family Medicine Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 143 S John Sims Pkwy, Valparaiso, Florida |
| Authorized Official Name and Position | Deann Marie Castaneda (OFFICE MANAGER) |
| Authorized Official Contact | 8507293300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Family Medicine Inc 143 S John Sims Pkwy Valparaiso FL 32580-1271 Ph: (850) 729-3300 | Emerald Coast Family Medicine Inc 143 S John Sims Pkwy Valparaiso FL 32580-1271 Ph: (850) 729-3300 |
| NPI Number | 1093937963 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 1759488133 |
|---|---|
| Medicare Enrollment ID | O20070518000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093937963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME97507 (Florida) | Primary |
| Provider Name | Thaddaeus Castaneda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710920897 PECOS PAC ID: 0446154884 Enrollment ID: I20070405000159 |
Wyndal K Blankenship Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 S John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-678-6621 Fax: 850-729-0331 | |
Donald B. Schak Sr., M.d., Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 S John Sims Pkwy, Suite C, Valparaiso, FL 32580 Phone: 850-678-0061 Fax: 850-678-0068 |