Organization
GULF EMERGENCY SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA SUE WILLIAMS MD (PRESIDENT)
(850) 249-6114
Entity
Organization
Contact information
Practice address
449 W 23RD ST, PANAMA CITY, FL 32405-4507
(850) 249-6114
Mailing address
PO BOX 11317, DAYTONA BEACH, FL 32120-1317
(386) 274-7800
(386) 274-7801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145230512A
—
GA
05
—
379320600
—
FL
01
—
40472
BLUE CROSS OF FLORIDA
FL
Enumeration date
06/03/2006
Last updated
07/30/2009
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