# EMERALD COAST INFECTIOUS DISEASES MEDICAL GROUP, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** American Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548069263
- **Authorized official:** KELLEY GEAR (ASSISTANT PRACTICE MANAGER)
- **Authorized official phone:** (850) 862-3979

## Contact information

- **Practice address:** 137 CRYSTAL BEACH DR STE 121, DESTIN, FL 32541-3573
- **Practice address phone:** (850) 807-4388
- **Mailing address:** 917 MAR WALT DR, FORT WALTON BEACH, FL 32547-6651
- **Mailing address phone:** (850) 862-3979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 03/13/2025
- **Last updated:** 03/13/2025