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Organization
EMERALD COAST SURGERY CENTER, LP
Active
Organization
EMERALD COAST SURGERY CENTER, LP
Active
Other names
Emerald Coast Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNE KACHELHOFFER (ADMINISTRATOR)
(850) 863-8165
Entity
Organization
Contact information
Practice address
995 MAR WALT DRIVE, FORT WALTON BEACH, FL 32547
(850) 863-7887
(850) 863-6645
Mailing address
995 MAR WALT DRIVE, FORT WALTON BEACH, FL 32547
(850) 863-7887
(850) 863-6645
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
996
FL
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0791423
—
FL
Enumeration date
04/20/2006
Last updated
01/27/2015
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