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General NPI Number Information
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NPI Number | 1629475033
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Entity Type | Organization
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Legal Business Name | PENSACOLA PHYSICAL MEDICINE INC
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 9007 UNIVERSITY PKWY
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City | PENSACOLA
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State | FL
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Zip | 32514-5525
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Country | US
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Telephone | 850-476-5420
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Fax | 850-476-5422
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Provider Business Mailing Address
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Address Line | 9007 UNIVERSITY PKWY
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City | PENSACOLA
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State | FL
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Zip | 32514-5525
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Country | US
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Telephone | 850-476-5420
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Fax | 850-476-5422
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER A SMITH
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Credential | D.C.
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Telephone | 850-476-5420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 9119
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9212528
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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