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4304 Lancaster Dr Niceville FL 32578-4563 | |
| (850) 862-2385 | |
| (850) 862-0482 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Nephrology |
| Location | 4304 Lancaster Dr, Niceville, 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) 444-7000 | 4304 Lancaster Dr Niceville FL 32578-4563 Ph: (850) 862-2385 |
| NPI Number | 1477501153 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 02/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477501153 | NPI | - | NPPES |
| 256870500 | Medicaid | FL | |
| 256870501 | Medicaid | FL | |
| 256870503 | Medicaid | FL | |
| 256870502 | Medicaid | FL | |
| 256870504 | Medicaid | FL | |
| 256870507 | Medicaid | FL | |
| 256870508 | Medicaid | FL | |
| 256870505 | Medicaid | FL | |
| 256870506 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
Rose Family Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4400 E Highway 20 Ste 207, Niceville, FL 32578 Phone: 850-806-2440 | |
Emerald Coast Health Institute, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4566 E Highway 20, Niceville, FL 32578 Phone: 850-279-6949 Fax: 850-279-6957 | |
Pat T. Tidwell Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4554 Highway 20 East, Niceville, FL 32578 Phone: 850-678-6735 Fax: 850-678-8078 | |
Mark E. Schroeder M.d.pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 College Blvd W, Suite C, Niceville, FL 32578 Phone: 850-678-3994 | |
Julie Staats Do Family Medicine Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2600 Partin Dr N Ste 120, Niceville, FL 32578 Phone: 850-279-3040 Fax: 850-279-3312 | |
Select Physical Therapy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 554 Twin Cities Blvd Ste A, Niceville, FL 32578 Phone: 850-729-3325 |