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General NPI Number Information
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NPI Number | 1760786891
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Entity Type | Individual
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Provider Name | ADAM GIST DPT
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Gender | Male
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 410 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32501-3919
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Country | US
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Telephone | 850-332-7681
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Fax | 850-512-1188
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Provider Business Mailing Address
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Address Line | PO BOX 6568
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City | PENSACOLA
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State | FL
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Zip | 32503-0568
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Country | US
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Telephone | 850-332-7681
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Fax | 850-512-1188
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 35727
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT35727
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License Number State | FL
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