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General NPI Number Information
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NPI Number | 1962129197
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Entity Type | Organization
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Legal Business Name | PNS23AH01 LLC
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 4711 SCENIC HWY
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City | PENSACOLA
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State | FL
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Zip | 32504-9018
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Country | US
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Telephone | 904-503-1065
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Fax | 904-374-6075
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Provider Business Mailing Address
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Address Line | 17 NW 33RD CT
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City | GAINESVILLE
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State | FL
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Zip | 32607-2552
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | DR. ALEX HUGGINS
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Credential | DC
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Telephone | 561-222-8208
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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 |
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License Number State |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 2084P0301X
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Taxonomy Name | Brain Injury Medicine (Psychiatry & Neurology) Physician
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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