Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
NORTH LAGOON MEDICAL, LLC
Active
Organization
NORTH LAGOON MEDICAL, LLC
Active
Other names
Crest Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH ALDRIDGE PA (MGR)
(352) 504-8546
Entity
Organization
Contact information
Practice address
8317 FRONT BEACH RD STE 37B, PANAMA CITY BEACH, FL 32407-4896
(352) 504-8546
Mailing address
8317 FRONT BEACH RD, PANAMA CITY BEACH, FL 32407-4885
(352) 504-8546
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3330
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292267300
—
FL
01
—
S74011
UPIN
FL
01
—
Y0A3J
BCBS
FL
Enumeration date
06/20/2013
Last updated
06/20/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up