Healthcare Provider Details

I. General information

NPI: 1134824543
Provider Name (Legal Business Name): ALLERGY & ASTHMA CENTER OF NORTHWEST FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 AIRPORT RD
DESTIN FL
32541-2803
US

IV. Provider business mailing address

6160 N DAVIS HWY STE 3
PENSACOLA FL
32504-6967
US

V. Phone/Fax

Practice location:
  • Phone: 850-654-4641
  • Fax: 850-654-9295
Mailing address:
  • Phone: 850-473-1121
  • Fax: 850-473-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS WESTBROOK
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 850-654-4641