Organization
NAVARRE PEDIATRICS PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEBA ELGOWENI M.D. (PROVIDER)
(850) 939-5550
Entity
Organization
Contact information
Practice address
8880 NAVARRE PKWY STE 102, NAVARRE, FL 32566-3613
(850) 939-5550
(850) 939-5445
Mailing address
8880 NAVARRE PKWY STE 102, NAVARRE, FL 32566-3613
(850) 939-5550
(850) 939-5445
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268997900
—
FL
01
—
34960
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
01
—
591-68789
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
06/25/2006
Last updated
05/08/2008
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