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EMERALD COAST NEONATOLOGY PA NPI 1285726091


NPI Information

NPI: 1285726091
Provider Name: EMERALD COAST NEONATOLOGY PA
Classification: Pediatrics - 2080P0203X
Entity Type: Organization

Specialization: Pediatric Critical Care Medicine

Address:
4250 HOSPITAL DRIVE
MARIANNA, FL
ZIP 32446
Phone: (850) 265-9332
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EMERALD COAST NEONATOLOGY PA is a pediatric critical care medicine pediatrics in Marianna, FL. The provider is a pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. EMERALD COAST NEONATOLOGY PA NPI is 1285726091. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4250 HOSPITAL DRIVE
MARIANNA, FL
ZIP 32446
Phone: (850) 265-9332
Fax: (850) 784-7706

The provider's authorized official is Douglas Sprague .
The authorized official title is President and has the following contact phone number (850) 265-9332.

The enumeration date for this NPI number is 9/29/2006 and was last updated on 1/22/2009.


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
12080P0203XPediatricsPediatric Critical Care MedicineME66820FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E90941MEDICARE UPINFLORIDA
2260912600MEDICAIDFLORIDA
345706OTHERFLORIDABCBS FLORIDA

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: 5/5/2024

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