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General NPI Number Information
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NPI Number | 1952964132
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Entity Type | Organization
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Legal Business Name | KOLBE CLINIC OF FLORIDA, LLC
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 8734 ORTEGA PARK DR
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City | NAVARRE
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State | FL
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Zip | 32566-4139
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Country | US
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Telephone | 850-904-2277
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Fax | 205-618-9706
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Provider Business Mailing Address
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Address Line | 8734 ORTEGA PARK DR
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City | NAVARRE
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State | FL
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Zip | 32566-4139
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Country | US
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Telephone | 850-904-2277
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Fax | 205-618-9706
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIAM CARL WAINSCOTT II
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Credential |
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Telephone | 850-904-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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