Organization
EMERALD COAST SURGERY CENTER, LP
Active
Other names
Emerald Coast Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNE KACHELHOFFER (ADMINISTRATOR)
(850) 863-8165
Entity
Organization
Contact information
Practice address
995 MAR WALT DRIVE, FORT WALTON BEACH, FL 32547
(850) 863-7887
(850) 863-6645
Mailing address
995 MAR WALT DRIVE, FORT WALTON BEACH, FL 32547
(850) 863-7887
(850) 863-6645
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
996
FL
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0791423
—
FL
Enumeration date
04/20/2006
Last updated
01/27/2015
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