Organization
EMERALD COAST CENTER FOR NEUROLOGICAL DISORDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONETTE MITCHEM (PRACTICE MANAGER)
(850) 438-1136
Entity
Organization
Contact information
Practice address
1110 AIRPORT BLVD, STE B, PENSACOLA, FL 32504-8649
(850) 438-1136
(850) 438-1148
Mailing address
1110 AIRPORT BLVD, STE B, PENSACOLA, FL 32504-8649
(850) 438-1136
(850) 438-1148
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275377400
—
FL
Enumeration date
10/06/2014
Last updated
02/28/2024
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