Organization
EMERALD COAST PULMONOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE KOSZUTA (DIRECTOR)
(850) 423-1311
Entity
Organization
Contact information
Practice address
502 E HICKORY AVE, CRESTVIEW, FL 32536-2742
(850) 423-1311
(850) 423-1313
Mailing address
502 E HICKORY AVE, CRESTVIEW, FL 32536-2742
(850) 423-1311
(850) 423-1313
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME63871
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME63871
FL
Other
Enumeration date
10/05/2006
Last updated
03/18/2011
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