Organization
DESTIN PULMONARY CRITICAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PANDRA MAE YERBY (BILLING SUPERVISOR)
(850) 608-6288
Entity
Organization
Contact information
Practice address
249 MACK BAYOU LOOP STE 201, SANTA ROSA BEACH, FL 32459-7197
(850) 608-6288
(850) 608-6236
Mailing address
249 MACK BAYOU LOOP STE 201, SANTA ROSA BEACH, FL 32459-7197
(850) 608-6288
(850) 608-6236
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014076700
—
FL
Enumeration date
12/05/2014
Last updated
09/12/2018
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