SALT AND IVY GULF LLC NPI 1073372124

NPI Information

  • NPI: 1073372124
  • Provider Name: SALT AND IVY GULF LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 101 GOOD MORNING ST STE 109B
    PORT ST JOE, FL
    ZIP 32456
  • Phone: (850) 357-8192

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NPI Details

SALT AND IVY GULF LLC is a family medicine in Port St Joe, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SALT AND IVY GULF LLC NPI is 1073372124. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

101 GOOD MORNING ST STE 109B
PORT ST JOE, FL
ZIP 32456-765
Phone: (850) 357-8192
Fax: (850) 659-9565

The provider's authorized official is Brittany Gardner Mccroan .
The authorized official title is Nurse Practitioner/ Owner and has the following contact phone number (850) 357-8192.

The enumeration date for this NPI number is 3/18/2024 and was last updated on 3/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 11/21/2025

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