Organization
EMERALD COAST MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETE PINAUD (PRINCIPAL)
(727) 849-9645
Entity
Organization
Contact information
Practice address
101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL 32435-6323
(850) 892-6001
(850) 892-4212
Mailing address
101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL 32435-6323
(850) 892-6001
(850) 892-4212
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34131
BCBS NON PAR NUMBER
FL
Enumeration date
05/24/2006
Last updated
10/09/2007
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