Emerald Coast Urology
Urology in Fort Walton Beach, FL. Organization (NPI-2).
NPI number1891729026
StatusActive
Last updated in NPPESFeb 27, 2008
Details
- NPI
- 1891729026
- Entity type
- Organization (NPI-2)
- Legal business name
- Emerald Coast Urology
- Organization subpart
- No
- Enumeration date
- Jul 11, 2006
- Last updated
- Feb 27, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | ME0043999 | FL | Yes |
Practice location
909 Mar Walt DrSuite 1011
Fort Walton Beach, FL 32547-6635
Phone 850-863-3377
Mailing address
909 Mar Walt DrSuite 1011
Fort Walton Beach, FL 32547-6635
Phone 850-863-3377
Authorized official
Leslie Cooper
Office Manager
8508633377
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