Organization
WEST FLORIDA GULF COAST PRIMARY CARE
Active
Other names
Greater Gulf Coast Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
JASON K HARVEY (EXECUTIVE DIRECTOR)
(850) 479-4858
Entity
Organization
Contact information
Practice address
1921 E NINE MILE RD, PENSACOLA, FL 32514-7747
(850) 479-4858
(850) 494-2260
Mailing address
1921 E NINE MILE RD, PENSACOLA, FL 32514-7747
(850) 479-4858
(850) 494-2260
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001169200
—
FL
01
—
98338
BCBS
FL
Enumeration date
07/15/2010
Last updated
07/15/2010
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