Organization
WEST FLORIDA MEDICAL CENTER CLINIC PA
Active
Parent organization
WEST FLORIDA MEDICAL CENTER CLINIC PA
Other names
Medical Center Clinic Ambulatory Surgical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST FLORIDA MEDICAL CENTER CLINIC PA
Authorized official
MARSHALL ANDY POPPLE (PRESIDENT)
(850) 474-8724
Entity
Organization
Contact information
Practice address
8333 N DAVIS HWY, PENSACOLA, FL 32514-6050
(850) 969-2121
(850) 969-2989
Mailing address
8333 N DAVIS HWY, PENSACOLA, FL 32514-6050
(850) 969-2121
(850) 969-2989
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079184900
—
FL
01
—
490002804
PALMETO MEDICARE
GA
01
—
64C
BLUE CROSS OF FLORIDA
—
01
—
68-01811
UNITED HEALTH CARE
—
Enumeration date
10/31/2006
Last updated
02/13/2012
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