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FT WALTON BEACH INTERNAL MEDICINE LLC NPI 1912928896


NPI Information

NPI: 1912928896
Provider Name: FT WALTON BEACH INTERNAL MEDICINE LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
1032 MAR WALT DR
SUITE 230
FORT WALTON BEACH, FL
ZIP 32547
Phone: (850) 862-0318
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FT WALTON BEACH INTERNAL MEDICINE LLC is an internal medicine in Fort Walton Beach, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. FT WALTON BEACH INTERNAL MEDICINE LLC NPI is 1912928896. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1032 MAR WALT DR
SUITE 230
FORT WALTON BEACH, FL
ZIP 32547-645
Phone: (850) 862-0318
Fax: (850) 862-2887

The provider's authorized official is Mickey Pickler .
The authorized official title is Vp and has the following contact phone number (850) 523-2117.

The enumeration date for this NPI number is 7/23/2006 and was last updated on 6/23/2008.


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
1207R00000XInternal MedicineYes

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
1DH1185MEDICARE 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

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.