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EMERALD COAST ONCOLOGY AND HEMATOLOGY ASSOC. P.A. NPI 1861421919


NPI Information

NPI: 1861421919
Provider Name: EMERALD COAST ONCOLOGY AND HEMATOLOGY ASSOC., P.A.
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 10D0271526

Address:
1024 MAR WALT DR
FORT WALTON BEACH, FL
ZIP 32547
Phone: (850) 863-3148
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EMERALD COAST ONCOLOGY AND HEMATOLOGY ASSOC., P.A. is a hematology and oncology internal medicine in Fort Walton Beach, FL. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. EMERALD COAST ONCOLOGY AND HEMATOLOGY ASSOC., P.A. NPI is 1861421919. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1024 MAR WALT DR
FORT WALTON BEACH, FL
ZIP 32547-645
Phone: (850) 863-3148

The provider's authorized official is Cynthia Vinson .
The authorized official title is PRACTICE MANAGERManager and has the following contact phone number (850) 863-3148.

The CLIA number assigned to this NPI record is 10D0271526 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/1/2006 and was last updated on 7/1/2015.


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
1207RH0003XInternal MedicineHematology & OncologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
133853MEDICARE PINFLORIDA

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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