Provider Type Icon

NORTH LAGOON MEDICAL LLC NPI 1770922007


NPI Information

NPI: 1770922007
Provider Name: NORTH LAGOON MEDICAL, LLC

Doing Business As: CREST MEDICAL CENTER

Classification: Physician Assistant - 363A00000X
Entity Type: Organization
Address:
8317 FRONT BEACH RD STE 37B
PANAMA CITY BEACH, FL
ZIP 32407
Phone: (352) 504-8546
Get Directions

NORTH LAGOON MEDICAL, LLC is a physician assistant in Panama City Beach, FL. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. NORTH LAGOON MEDICAL, LLC NPI is 1770922007. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Crest Medical Center.

The provider's business location address is:

8317 FRONT BEACH RD STE 37B
PANAMA CITY BEACH, FL
ZIP 32407-896
Phone: (352) 504-8546

The provider's authorized official is Ronald Joseph Aldridge .
The authorized official title is Mgr and has the following contact phone number (352) 504-8546.

The enumeration date for this NPI number is 6/20/2013 and was last updated on 6/20/2013.


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
1363A00000XPhysician AssistantPA3330FLORIDAYes

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
1S74011OTHERFLORIDAUPIN
2E2139RMEDICARE UPINFLORIDA
3Y0A3JOTHERFLORIDABCBS
4292267300MEDICAIDFLORIDA

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

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.