Organization
EMERALD COAST PEDIATRICS & ADOLESCENTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EEHAB A KENAWY M.D. (OWNER)
(850) 747-3661
Entity
Organization
Contact information
Practice address
621 W BALDWIN RD STE A, PANAMA CITY, FL 32405-3364
(850) 747-3661
(850) 747-0194
Mailing address
621 W BALDWIN RD STE A, PANAMA CITY, FL 32405-3364
(850) 747-3661
(850) 747-0194
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME86651
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266831900
—
FL
Enumeration date
05/03/2016
Last updated
05/03/2016
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