EMERALD COAST NECK & BACK CLINIC P.A. NPI 1386916237

NPI Information

NPI: 1386916237
Provider Name: EMERALD COAST NECK & BACK CLINIC, P.A.
Classification: Orthopaedic Surgery - 207XS0117X
Specialization: Orthopaedic Surgery of the Spine
Entity Type: Organization
Address: 1003 COLLEGE BLVD W
SUITE 4
NICEVILLE, FL
ZIP 32578
Phone: (850) 279-6485

Map and Directions

Get Directions

NPI Details

EMERALD COAST NECK & BACK CLINIC, P.A. is an orthopaedic surgery of the spine orthopaedic surgery in Niceville, FL. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. EMERALD COAST NECK & BACK CLINIC, P.A. NPI is 1386916237. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1003 COLLEGE BLVD W
SUITE 4
NICEVILLE, FL
ZIP 32578-068
Phone: (850) 279-6485
Fax: (850) 279-6546

The provider's authorized official is Christo W. Koulisis .
The authorized official title is President and has the following contact phone number (850) 279-6485.

The enumeration date for this NPI number is 2/7/2012 and was last updated on 12/29/2022.

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
1	207X00000X	Orthopaedic Surgery		ME0053933	FLORIDA	No
2	207XS0117X	Orthopaedic Surgery	Orthopaedic Surgery of the Spine	ME0053933	FLORIDA	Yes

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
1	162510700	OTHER	FLORIDA	DEPARTMENT OF LABOR
2	07915	OTHER	FLORIDA	BLUE CROSS BLUE SHIELD
3	256355000	MEDICAID	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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI