| |
5149 N 9th Ave Suite G35 Pensacola FL 32504-8756 | |
(850) 471-1445 | |
(850) 471-9705 |
Full Name | |
---|---|
Speciality | Internal Medicine - Nephrology |
Location | 5149 N 9th Ave, Pensacola, 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 | 5149 N 9th Ave Suite G35 Pensacola FL 32504-8756 Ph: (850) 471-1445 |
NPI Number | 1467495424 |
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Provider Enumeration Date | 06/14/2006 |
Last Update Date | 02/07/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467495424 | NPI | - | NPPES |
256870505 | Medicaid | FL | |
256870506 | Medicaid | FL | |
529904030 | Medicaid | AL | |
256870508 | Medicaid | FL | |
CF9776 | Other | RR MEDICARE | |
256870502 | Medicaid | FL | |
256870503 | Medicaid | FL | |
0358 | Other | FL | MED3000/HEALTH 1ST NETWOR |
256870504 | Medicaid | FL | |
256870501 | Medicaid | FL | |
256870507 | Medicaid | FL | |
256870500 | Medicaid | FL | |
99659 | Other | FL | BCBS OF FLORIDA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
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