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Organization

NORTHWEST FLORIDA A S C LP

Active
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Organization

NORTHWEST FLORIDA A S C LP

Active
Other names
Northwest Florida Gastroenterology Center
Organization subpart
No

Provider details

NPI number
Authorized official
KELLEE MANNING (ADMINISTRATOR)
(850) 769-7599
Entity
Organization

Contact information

Practice address
204B E 19TH ST, PANAMA CITY, FL 32405-4707
(850) 769-7599
(850) 769-7389
Mailing address
204B E 19TH ST, PANAMA CITY, FL 32405-4707
(850) 769-7599
(850) 215-4381

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
952
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079136900
—
FL
01
—
P000962901
RAILROAD MEDICARE
FL
Enumeration date
01/20/2006
Last updated
07/10/2026
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