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General NPI Number Information
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NPI Number | 1013152487
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE ASSOCIATES OF THE EMERALD COAST P A
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 348 MIRACLE STRIP PKWY SW SUITE 23
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-5200
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Country | US
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Telephone | 850-269-2186
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Fax | 850-269-2341
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Provider Business Mailing Address
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Address Line | PO BOX 1646
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City | DESTIN
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State | FL
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Zip | 32540-1646
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Country | US
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Telephone | 850-269-2186
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Fax | 850-269-2341
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. ANA E LEURINDA
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Credential | MD
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Telephone | 850-269-2186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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