| Perdido Bay Family Care, Llc | |
|
10 Doug Ford Drive Pensacola FL 32507-4307 | |
| (850) 492-2010 | |
| (850) 492-2012 |
| Full Name | Perdido Bay Family Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10 Doug Ford Drive, Pensacola, Florida |
| Authorized Official Name and Position | Brian Mitchell Lee (PHYSICIAN OWNER) |
| Authorized Official Contact | 8504922010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Perdido Bay Family Care, Llc Po Box 34307 Pensacola FL 32507-4307 Ph: (850) 492-2010 | Perdido Bay Family Care, Llc 10 Doug Ford Drive Pensacola FL 32507-4307 Ph: (850) 492-2010 |
| NPI Number | 1174709489 |
|---|---|
| Provider Enumeration Date | 01/16/2008 |
| Last Update Date | 01/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174709489 | NPI | - | NPPES |
| K5362 | Other | FL | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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