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NPI Code Detail

MEDICARE: PSGFL MSSP, LLC

MEDICARE: PSGFL MSSP, LLC
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1689557936
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSGFL MSSP, LLC
Provider Business Mailing Address
First Line : 3000 GULF BREEZE PKWY
Second Line :
City : GULF BREEZE
State : FL
Zip : 32563-5623
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3000 GULF BREEZE PKWY
Second Line :
City : GULF BREEZE
State : FL
Zip : 32563-5623
Country : US
Telephone Number : 864-303-8650
Fax Number :
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : CHRISTOPHER R DENAPOLES, M.D.
Credential :
Telephone Number : 864-303-8650
Provider Enumeration Date : 07/25/2025
Last Update Date : 04/23/2026

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