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General NPI Number Information
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NPI Number | 1902850258
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Entity Type | Organization
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Legal Business Name | PANHANDLE ORTHOPAEDICS LLC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 2401 LANGLEY AVE UNIT B
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City | PENSACOLA
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State | FL
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Zip | 32504-8922
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Country | US
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Telephone | 850-407-7840
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Fax | 850-407-7839
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Provider Business Mailing Address
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Address Line | 2401 LANGLEY AVE UNIT B
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City | PENSACOLA
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State | FL
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Zip | 32504-8922
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Country | US
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Telephone | 850-407-7840
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Fax | 850-407-7839
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MICHAEL D GILMORE
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Credential | MD
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Telephone | 850-407-7840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | FL
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