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5976 Berryhill Rd Ste A Milton FL 32570-4009 | |
| (850) 623-4771 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 5976 Berryhill Rd Ste A, Milton, Florida |
| Authorized Official Name and Position | Justin Dansby (CFO) |
| Authorized Official Contact | 8504444700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 11037 Pensacola FL 32524-1037 Ph: (850) 444-4700 | 5976 Berryhill Rd Ste A Milton FL 32570-4009 Ph: (850) 623-4771 |
| NPI Number | 1447930656 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 02/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447930656 | NPI | - | NPPES |
| 256870500 | Medicaid | FL | |
| 256870504 | Medicaid | FL | |
| 256870501 | Medicaid | FL | |
| 256870502 | Medicaid | FL | |
| 256870503 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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