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Organization
WEST FLORIDA GULF COAST PRIMARY CARE
Active
Organization
WEST FLORIDA GULF COAST PRIMARY CARE
Active
Other names
Greater Gulf Coast Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
JASON K HARVEY (EXECUTIVE DIRECTOR)
(850) 479-4858
Entity
Organization
Contact information
Practice address
1921 E NINE MILE RD, PENSACOLA, FL 32514-7747
(850) 479-4858
(850) 494-2260
Mailing address
1921 E NINE MILE RD, PENSACOLA, FL 32514-7747
(850) 479-4858
(850) 494-2260
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001169200
—
FL
01
—
98338
BCBS
FL
Enumeration date
07/15/2010
Last updated
07/15/2010
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