Organization
NORTHWEST FLORIDA CARDIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICKEY PICKLER (VP)
(850) 523-2117
Entity
Organization
Contact information
Practice address
490 HIGHWAY 85 N, STE A & B, NICEVILLE, FL 32578-1010
(850) 678-6501
(850) 678-6516
Mailing address
490 HIGHWAY 85 N, STE A & B, NICEVILLE, FL 32578-1010
(850) 678-6501
(850) 678-6516
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF1366
RAILROAD MEDICARE
FL
Enumeration date
12/05/2005
Last updated
05/10/2010
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