Organization
SURFSIDE FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLGA DORJIMA EMGUSHOV MD (OWNER/PHYSICIAN)
(321) 799-2554
Entity
Organization
Contact information
Practice address
3000 N ATLANTIC AVE STE 108, COCOA BEACH, FL 32931-5029
(321) 799-2554
(321) 799-4750
Mailing address
3000 N ATLANTIC AVE STE 108, COCOA BEACH, FL 32931-5029
(321) 799-2554
(321) 799-4750
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME94076
FL
Other
Enumeration date
08/19/2009
Last updated
08/19/2009
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