Organization
SAMUEL D. CRITIDES, JR., M.D., P.A.
Active
Other names
HOMEPORT NEUROSURGERY AND SPINE
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL D CRITIDES JR. MD (OWNER/ P, S)
(850) 374-3125
Entity
Organization
Contact information
Practice address
350G RACETRACK RD NW, FORT WALTON BEACH, FL 32547-1699
(850) 374-3125
(850) 226-5544
Mailing address
350G RACETRACK RD NW, FORT WALTON BEACH, FL 32547-1699
(850) 374-3125
(850) 226-5544
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
07/11/2023
Last updated
04/01/2026
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