| Emerald Coast Infectious Diseases Medical Group, P.a. | |
|
917 Mar Walt Dr Fort Walton Beach FL 32547-6759 | |
| (850) 862-3979 | |
| Not Available |
| Full Name | Emerald Coast Infectious Diseases Medical Group, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 917 Mar Walt Dr, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Sandy Anastasio (OFFICE MANAGER) |
| Authorized Official Contact | 8508623979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Infectious Diseases Medical Group, P.a. 917 Mar Walt Dr Fort Walton Beach FL 32547-6759 Ph: (850) 862-3979 | Emerald Coast Infectious Diseases Medical Group, P.a. 917 Mar Walt Dr Fort Walton Beach FL 32547-6759 Ph: (850) 862-3979 |
| NPI Number | 1720017882 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 04/25/2008 |
| Medicare PECOS PAC ID | 5092753772 |
|---|---|
| Medicare Enrollment ID | O20050422000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720017882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Patrick John Anastasio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598731770 PECOS PAC ID: 6800834581 Enrollment ID: I20050425000690 |
| Provider Name | Hemant R Kade |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841539541 PECOS PAC ID: 6709012479 Enrollment ID: I20131202001797 |
| Provider Name | Crystal Gayle Mcvay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710405519 PECOS PAC ID: 5395097307 Enrollment ID: I20181002002549 |
| Provider Name | Michael Vincent Florendo Tablang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1679763387 PECOS PAC ID: 7113173279 Enrollment ID: I20190401000180 |
| Provider Name | Mario Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679117451 PECOS PAC ID: 4688003510 Enrollment ID: I20200329000151 |
| Provider Name | Jeffrey Lin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1639622665 PECOS PAC ID: 8820386030 Enrollment ID: I20210520002365 |
| Provider Name | Sherri L Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548904360 PECOS PAC ID: 8426439910 Enrollment ID: I20220714002352 |
| Provider Name | Howard M Kussman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447293287 PECOS PAC ID: 3375442163 Enrollment ID: I20230330002246 |
| Provider Name | Michael R Chambers |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194259523 PECOS PAC ID: 5496026494 Enrollment ID: I20230515001585 |
| Provider Name | Rayen Ayoub Chakra |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033608765 PECOS PAC ID: 9335484674 Enrollment ID: I20230623001062 |
| Provider Name | Jill M Bilek |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497243331 PECOS PAC ID: 5294075800 Enrollment ID: I20230913002130 |
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Family Medicine Associates Of The Emerald Coast P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 348 Miracle Strip Pkwy Sw, Suite 23, Fort Walton Beach, FL 32548 Phone: 850-269-2186 Fax: 850-269-2341 | |
James P Wilson Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Cloverdale Blvd, Fort Walton Beach, FL 32547 Phone: 850-862-7604 Fax: 850-862-8156 | |
Glass Inpatient Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-862-1111 | |
White-wilson Med Ctr-fwb Fp Dept Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 Mar Walt Dr, Fp Department, Fort Walton Beach, FL 32547 Phone: 850-863-6600 Fax: 850-862-0977 | |
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