Organization
SOUTHEASTERN INTERVENTIONAL PAIN PHYSICIANS, P.A.
Active
Other names
EMERALD COAST PAIN PHYSICIANS
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA NEWSOM (MEDICAL BILLER)
(850) 243-7788
Entity
Organization
Contact information
Practice address
151 MARY ESTHER BLVD, SUITE 303, MARY ESTHER, FL 32569-1972
(850) 243-7788
(850) 243-7738
Mailing address
PO BOX 699, GULF BREEZE, FL 32562-0699
(850) 243-7788
(850) 243-7738
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45117
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/26/2006
Last updated
08/22/2020
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