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NORTHWEST FLORIDA ENT PA NPI 1821466491


NPI Information

NPI: 1821466491
Provider Name: NORTHWEST FLORIDA ENT PA
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 10D2145679

Address:
310 RACETRACK RD NW STE 100
FORT WALTON BEACH, FL
ZIP 32547
Phone: (850) 889-4550
Get Directions

NORTHWEST FLORIDA ENT PA is an otolaryngology in Fort Walton Beach, FL. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. NORTHWEST FLORIDA ENT PA NPI is 1821466491. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

310 RACETRACK RD NW STE 100
FORT WALTON BEACH, FL
ZIP 32547-553
Phone: (850) 889-4550
Fax: (850) 889-4549

The provider's authorized official is Jason Redwood Boole .
The authorized official title is President and has the following contact phone number (850) 889-4550.

The CLIA number assigned to this NPI record is 10D2145679 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/12/2015 and was last updated on 4/13/2019.


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
1207YS0012XOtolaryngologySleep MedicineME96773FLORIDANo
2207YX0602XOtolaryngologyOtolaryngic AllergyME96773FLORIDANo
3207Y00000XOtolaryngologyME96773FLORIDAYes

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: 4/28/2024

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