Organization
EMERALD COAST INFECTIOUS DISEASES MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY GEAR (ASSISTANT PRACTICE MANAGER)
(850) 862-3979
Entity
Organization
Contact information
Practice address
351 N FERDON BLVD, CRESTVIEW, FL 32536-2727
(850) 862-3979
Mailing address
917 MAR WALT DR, FORT WALTON BEACH, FL 32547-6651
(850) 862-3979
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
03/13/2025
Last updated
03/13/2025
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