| North Okaloosa Clinic Corp | |
|
550 Redstone Ave W Ste. 370 Crestview FL 32536-6428 | |
| (850) 682-2209 | |
| (850) 682-2528 |
| Full Name | North Okaloosa Clinic Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 550 Redstone Ave W, Crestview, Florida |
| Authorized Official Name and Position | Kristina Music (DIRECTOR,PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Okaloosa Clinic Corp Po Box 689022 Franklin TN 37068-9022 Ph: (615) 628-6038 | North Okaloosa Clinic Corp 550 Redstone Ave W Ste. 370 Crestview FL 32536-6428 Ph: (850) 682-2209 |
| NPI Number | 1659329852 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 09/23/2024 |
| Medicare PECOS PAC ID | 0244205565 |
|---|---|
| Medicare Enrollment ID | O20040831000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659329852 | NPI | - | NPPES |
| 273693400 | Medicaid | FL | |
| 33565 | Other | FL | BCBS |
| Provider Name | Michelle H Vandenbosch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023205051 PECOS PAC ID: 7517862279 Enrollment ID: I20031204001140 |
| Provider Name | Joel A Rubenstein |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306815337 PECOS PAC ID: 6800825902 Enrollment ID: I20050809000807 |
| Provider Name | Janet Hamby |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528258159 PECOS PAC ID: 7810012671 Enrollment ID: I20100916000647 |
| Provider Name | Gus J Leotta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336220771 PECOS PAC ID: 0345419222 Enrollment ID: I20110810000311 |
| Provider Name | Colette Reahl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184875692 PECOS PAC ID: 4789854969 Enrollment ID: I20110825000338 |
| Provider Name | Gregory A Coates |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033320312 PECOS PAC ID: 6800066887 Enrollment ID: I20110830000640 |
| Provider Name | Tiffany Lee Kruger |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1295981066 PECOS PAC ID: 0648414961 Enrollment ID: I20130926000101 |
| Provider Name | Mervin Manuel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215070396 PECOS PAC ID: 4789777939 Enrollment ID: I20151002001083 |
| Provider Name | David Dean |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043282528 PECOS PAC ID: 2163579764 Enrollment ID: I20151005001211 |
| Provider Name | Keely A Kubly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548526544 PECOS PAC ID: 7517276629 Enrollment ID: I20151012000808 |
| Provider Name | Ana May Magdalen Pascual Manuel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548498512 PECOS PAC ID: 0345497186 Enrollment ID: I20151019000525 |
| Provider Name | David Lalli |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851352322 PECOS PAC ID: 8628290202 Enrollment ID: I20161020002171 |
| Provider Name | Meredith A Flanagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639549066 PECOS PAC ID: 4981904513 Enrollment ID: I20170718000203 |
| Provider Name | Daran J Mason |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558576439 PECOS PAC ID: 2668531039 Enrollment ID: I20180926000202 |
| Provider Name | Deena Wise |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982683488 PECOS PAC ID: 7517031115 Enrollment ID: I20181023003362 |
| Provider Name | Jacob Randall Lassiter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295178580 PECOS PAC ID: 6406087428 Enrollment ID: I20190726000762 |
| Provider Name | Timothy Moses |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1700846656 PECOS PAC ID: 1254327695 Enrollment ID: I20200429000433 |
| Provider Name | Nadine Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104165802 PECOS PAC ID: 6507085727 Enrollment ID: I20210709001893 |
| Provider Name | Chase Douglas Henderson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467988048 PECOS PAC ID: 1153703517 Enrollment ID: I20220801002842 |
| Provider Name | Alexcia Pennell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407249691 PECOS PAC ID: 7315265816 Enrollment ID: I20230103000099 |
| Provider Name | Eliyahu Hemo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255627824 PECOS PAC ID: 7517277627 Enrollment ID: I20230308000358 |
| Provider Name | Joseph Pugh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275605834 PECOS PAC ID: 8022258391 Enrollment ID: I20231211003654 |
| Provider Name | Jodi Seabrook |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1851672992 PECOS PAC ID: 8426205683 Enrollment ID: I20240112002882 |
| Provider Name | Robert Mclean |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1558364398 PECOS PAC ID: 2961399092 Enrollment ID: I20240116003932 |
| Provider Name | Theron Jameson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932101466 PECOS PAC ID: 8729017819 Enrollment ID: I20240209003035 |
| Provider Name | Alana Louise Lilland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851970784 PECOS PAC ID: 5799125472 Enrollment ID: I20240429000870 |
Crestview Immediate Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4100 S Ferdon Blvd Ste A3, Crestview, FL 32536 Phone: 850-758-7791 | |
Marcene F. Kreifels, M.d., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1198 S Ferdon Blvd, Crestview, FL 32536 Phone: 850-682-1735 Fax: 850-689-4400 | |
Michael P Roberts Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 369 N Main St, Crestview, FL 32536 Phone: 850-398-6963 Fax: 850-398-8277 | |
Belfiore Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 502 E Hickory Ave, Crestview, FL 32536 Phone: 850-683-1100 Fax: 850-683-0599 | |
North Okaloosa Clinic Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1332 N Ferdon Blvd, Crestview, FL 32536 Phone: 850-398-8725 Fax: 850-398-8727 | |
Advanced Family Medicine Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 327 Medcrest Drive, Unit A, Crestview, FL 32536 Phone: 850-423-0761 Fax: 855-793-3568 | |
Crestview Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 800 Hospital Dr, Crestview, FL 32539 Phone: 850-682-1164 Fax: 850-682-5302 |