Organization
EMERALD COAST WELLNESS CENTER, LLC
Active
Organization
EMERALD COAST WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY ALEXANDER BOILINI MD (PSYCHIATRIST)
(850) 543-5678
Entity
Organization
Contact information
Practice address
138 BAYWIND DR, NICEVILLE, FL 32578-4800
(850) 398-4155
(850) 398-4142
Mailing address
138 BAYWIND DR, NICEVILLE, FL 32578-4800
(850) 398-4155
(850) 398-4142
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008056800
—
FL
Enumeration date
01/07/2010
Last updated
09/02/2015
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