Organization
CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA
Active
Parent organization
CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA
Authorized official
JAMES BEN RENFROE MD (PRESIDENT)
(850) 932-5055
Entity
Organization
Contact information
Practice address
12815 US HIGHWAY 98 W STE 116, MIRAMAR BEACH, FL 32550-3245
(850) 932-5055
(850) 932-1404
Mailing address
PO BOX 280, GULF BREEZE, FL 32562-0280
(850) 932-5055
(850) 932-1404
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/17/2025
Last updated
01/22/2025
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