Organization
BRIDGEWAY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE R BARLOW (CHIEF EXECUTIVE OFFICER)
(850) 833-3975
Entity
Organization
Contact information
Practice address
137 HOSPITAL DRIVE, FORT WALTON BEACH, FL 32548
(850) 833-7400
(850) 833-7434
Mailing address
137 HOSPITAL DRIVE, FORT WALTON BEACH, FL 32548
(850) 833-7400
(850) 833-7434
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z134K
BCBS
—
Enumeration date
05/07/2007
Last updated
11/26/2019
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