Organization
RADIANCE OF THE EMERALD COAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CANDACE COOLEY (PHYSICIAN)
(850) 586-7661
Entity
Organization
Contact information
Practice address
348 MIRACLE STRIP PKWY SW STE 15, FORT WALTON BEACH, FL 32548-5258
(850) 586-7661
Mailing address
348 MIRACLE STRIP PKWY SW STE 15, FORT WALTON BEACH, FL 32548-5258
(850) 586-7661
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME77965
FL
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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