MEDICARE: DESTIN OPHTHALMOLOGY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	ME90933	FL

General Provider Information

NPI Number	:	1144254939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESTIN OPHTHALMOLOGY PA

Provider Business Mailing Address
First Line	:	7700 US HIGHWAY 98 W
Second Line	:	SUITE 201
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-3270
Country	:	US
Telephone Number	:	850-622-0757
Fax Number	:	850-622-1978

Provider Business Practice Location Address
First Line	:	7700 US HIGHWAY 98 W
Second Line	:	SUITE 201
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-3270
Country	:	US
Telephone Number	:	850-622-0757
Fax Number	:	850-622-1978

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MRS. PRISCILLA G. FOWLER
Credential	:	M.D.
Telephone Number	:	850-622-0757

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/15/2010

Similar Medicare Providers

1003706813 — MONICAH WAITHIRA GACEGU
Practice Location Address:

2623 NAVAJO ST
SANTA ROSA, CA
95403-3270

Practice Phone: 707-703-2565
Practice Fax:

1437002672 — DIVINE FIJIANS HOME CARE
Practice Location Address:

3270 MENDOCINO AVE
SANTA ROSA, CA
95403-2263

Practice Phone: 916-391-8933
Practice Fax: 707-800-7679

1760747299 — MR. MARVIN ESGUERRA ANGELES P.T.
Practice Location Address:

3270 BENTON ST
SANTA CLARA, CA
95051-3739

Practice Phone: 707-217-4388
Practice Fax:

1386142164 — KIMBERLY CLAPP MARRIAGE AND FAMIY THERAPIST
Practice Location Address:

3301 OCEAN PARK BLVD STE 104
SANTA MONICA, CA
90405-3270

Practice Phone: 310-403-9180
Practice Fax:

1477206993 — MARC BENEDICT E BERNALDEZ MLS(ASCP)CM
Practice Location Address:

18054 EPIC LN
SANTA CLARITA, CA
91350-3270

Practice Phone: 818-687-6653
Practice Fax:

1265600191 — DYNAMIC DENTAL HEALTH ASSOCIATES OF FLORIDA, PA
Practice Location Address:

5180 PALM BEACH BLVD
FORT MYERS, FL
33905-3270

Practice Phone: 239-694-6161
Practice Fax: 239-694-0413

Directions to “DESTIN OPHTHALMOLOGY PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.