Organization
EMERALD COAST UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE COOPER (OFFICE MANAGER)
(850) 863-3377
Entity
Organization
Contact information
Practice address
909 MAR WALT DR, SUITE 1011, FORT WALTON BEACH, FL 32547-6635
(850) 863-3377
Mailing address
909 MAR WALT DR, SUITE 1011, FORT WALTON BEACH, FL 32547-6635
(850) 863-3377
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0043999
FL
Other
Enumeration date
07/11/2006
Last updated
02/27/2008
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