NORTHWEST FLORIDA A S C LP NPI 1992785232

NPI Information

NORTHWEST FLORIDA A S C LP is an ambulatory surgical clinic center in Panama City, FL. NORTHWEST FLORIDA A S C LP NPI is 1992785232. The provider is registered as an organization entity type.
The provider Is Doing Business As Northwest Florida Gastroenterology Center.

The provider's business location address is:

204B E 19TH ST
PANAMA CITY, FL
ZIP 32405-707
Phone: (850) 769-7599
Fax: (850) 769-7389

The provider's authorized official is Phillip A Clendenin .
The authorized official title is President Of General Partner Corp. and has the following contact phone number (615) 665-1283.

The CLIA number assigned to this NPI record is 10D0875450 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/20/2006 and was last updated on 2/12/2014.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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