Organization
OKALOOSA MENTAL HEALTH & PSYCHIATRIC CENTER, INC.
Active
Other names
Escambia NeuroPsychiatric Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIUMARS SHAMS MD (EXECUTIVE MEDICAL DIRECTOR)
(850) 432-3334
Entity
Organization
Contact information
Practice address
101 S JEFFERSON ST, SUITE C, PENSACOLA, FL 32502-5656
(850) 432-3334
(850) 432-3353
Mailing address
101 S JEFFERSON ST, SUITE C, PENSACOLA, FL 32502-5656
(850) 432-3334
(850) 432-3353
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
ME29949
FL
2084N0400X
Neurology Physician
ME29949
FL
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
ME29949
FL
2084P0005X
Neurodevelopmental Disabilities Physician
ME29949
FL
2084P0800X
Psychiatry Physician
Primary
ME29949
FL
2084P0802X
Addiction Psychiatry Physician
ME29949
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME29949
FL
2084P0805X
Geriatric Psychiatry Physician
ME29949
FL
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
ME29949
FL
208U00000X
Clinical Pharmacology Physician
ME29949
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038295700
—
FL
01
—
79178
BC BS FL
FL
Enumeration date
06/18/2007
Last updated
03/05/2012
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