Southcoast Allergy Pa

NPI 1508954470

Information of Southcoast Allergy Pa

The NPI 1508954470 is an Organization type. NPI No 1508954470 belongs to Southcoast Allergy Pa. Southcoast Allergy Pa specializes in Allergy & Immunology. is practising at 4400 E Highway 20, Niceville, Florida 32578. You can also contact him via phone number (850) 279-6520.

Practice address located

  • 4400 E Highway 20
  • Niceville, Florida 32578
  • (850) 279-6520
  • (850) 279-6520

Mailling address located

  • 1723 Wren Way
  • Niceville, Florida 32578
  • (850) 279-6520
  • (850) 897-1259
Southcoast Allergy Pa is PECOS enrolled.
NPI No 1508954470
Primary Taxonomy
Authorized Official
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
Yes207K00000XAllergy & ImmunologyME78816Florida
Identifier for this provider
StateIdentifierTypeIssuer
n/aG43429Medicare UPINn/a
FLME78816OtherDR.S MEDICAL LICENSE
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