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EMERALD COAST INTERNAL MEDICINE AND GERIATRICS LLC NPI 1114339074


NPI Information

NPI: 1114339074
Provider Name: EMERALD COAST INTERNAL MEDICINE AND GERIATRICS LLC
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 10D1004447

Address:
280 FOREST PARK CIR
PANAMA CITY, FL
ZIP 32405
Phone: (850) 896-9688
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EMERALD COAST INTERNAL MEDICINE AND GERIATRICS LLC is a geriatric medicine internal medicine in Panama City, FL. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. EMERALD COAST INTERNAL MEDICINE AND GERIATRICS LLC NPI is 1114339074. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

280 FOREST PARK CIR
PANAMA CITY, FL
ZIP 32405-919
Phone: (850) 896-9688
Fax: (850) 769-7717

The provider's authorized official is Emad A Eisa .
The authorized official title is Medical Doctor and has the following contact phone number (703) 598-6013.

The CLIA number assigned to this NPI record is 10D1004447 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2014 and was last updated on 9/24/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0300XInternal MedicineGeriatric MedicineME114732FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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