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General NPI Number Information
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NPI Number | 1992847230
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Entity Type | Organization
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Legal Business Name | GULF COAST ORTHOPEDIC SPECIALISTS
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1040 GULF BREEZE PKWY SUITE 204
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City | GULF BREEZE
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State | FL
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Zip | 32561-4838
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Country | US
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Telephone | 850-932-9401
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Fax |
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Provider Business Mailing Address
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Address Line | 4541 N DAVIS HWY SUITE A
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City | PENSACOLA
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State | FL
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Zip | 32503-2783
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Country | US
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Telephone | 850-494-9000
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Fax |
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Authorized Official
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Title or Position | SURGEON-PARTNER
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Name | ROBERT B CAMERON
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Credential | M.D.
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Telephone | 850-494-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | FL
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