| White Sands Integrative Medical, Inc. | |
|
24 Beal Pkwy Sw Fort Walton Beach FL 32548-5388 | |
| (850) 226-6728 | |
| (850) 226-6729 |
| Full Name | White Sands Integrative Medical, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 24 Beal Pkwy Sw, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Erik Ryan Persiani (PRESIDENT) |
| Authorized Official Contact | 8502266728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Sands Integrative Medical, Inc. 24 Beal Pkwy Sw Fort Walton Beach FL 32548-5388 Ph: (850) 226-6728 | White Sands Integrative Medical, Inc. 24 Beal Pkwy Sw Fort Walton Beach FL 32548-5388 Ph: (850) 226-6728 |
| NPI Number | 1447886916 |
|---|---|
| Provider Enumeration Date | 03/17/2020 |
| Last Update Date | 03/17/2020 |
| Medicare PECOS PAC ID | 6406254507 |
|---|---|
| Medicare Enrollment ID | O20211004002088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447886916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Erik Persiani |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265515100 PECOS PAC ID: 1355342734 Enrollment ID: I20070129000022 |
| Provider Name | Brittany Marie Arbacheski Fais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326607276 PECOS PAC ID: 9234467614 Enrollment ID: I20190822003017 |
| Provider Name | Patience Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235803164 PECOS PAC ID: 1456758093 Enrollment ID: I20210923002028 |
| Provider Name | Amanda Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205435518 PECOS PAC ID: 4183022205 Enrollment ID: I20211004002727 |
| Provider Name | Lisa M Haik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245938372 PECOS PAC ID: 1153785282 Enrollment ID: I20230907004340 |
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