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NPI Code Detail

MEDICARE: FLORIDA PANHANDLE PEDIATRIC FOUNDATION, INC.

MEDICARE: FLORIDA PANHANDLE PEDIATRIC FOUNDATION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2261QP2300XPrimary Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962478230
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA PANHANDLE PEDIATRIC FOUNDATION, INC.
Provider Business Mailing Address
First Line : 2814 W 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-1376
Country : US
Telephone Number : 850-872-4840
Fax Number : 850-872-4468
Provider Business Practice Location Address
First Line : 2814 W 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-1376
Country : US
Telephone Number : 850-872-4840
Fax Number : 850-872-4468
Authorized Official
Title or Position : PROJECT ADMINISTRATOR
Name : MS. PATTI A. WELCH
Credential : R.N.-BSN
Telephone Number : 850-872-4840
Provider Enumeration Date : 02/27/2006
Last Update Date : 03/12/2009

Similar Medicare Providers

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Practice Location Address:
2814 W 15TH ST
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32401-1376
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1780636001 — MS. PATTI A. WELCH RN-BSN
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1962454918 — MARGARET Y. DAVEY RN
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1093767048 — GLORIA L. ADAMS RN
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2814 W 15TH ST
PANAMA CITY, FL
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1275541047 — PENNIE DENISE MILLER RN
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1245325521 — KATHLEEN ANN SWAIN RN
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Directions to “FLORIDA PANHANDLE PEDIATRIC FOUNDATION, INC. ” Practice Location

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