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NPI Code Detail

MEDICARE: PANCARE OF FLORIDA, INC

MEDICARE: PANCARE OF FLORIDA, INC
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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1689487563
Entity Type Code : Organization
Provider Name (Legal Business Name) : PANCARE OF FLORIDA, INC
Provider Business Mailing Address
First Line : 403 E 11TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-3409
Country : US
Telephone Number : 850-747-5599
Fax Number : 850-874-4131
Provider Business Practice Location Address
First Line : 12427 HIGHWAY 231
Second Line :
City : YOUNGSTOWN
State : FL
Zip : 32466-2562
Country : US
Telephone Number : 850-753-3246
Fax Number : 850-753-3342
Authorized Official
Title or Position : BILLING MANAGER
Name : LAURA RILEY
Credential :
Telephone Number : 850-215-3578
Provider Enumeration Date : 01/27/2025
Last Update Date : 01/27/2025

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