CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA (NPI# 1053392233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053392233 |
| Entity Type | Organization |
| Organization Name | CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA |
| Practice Address |
400 Gulf Breeze Pkwy Suite 300 Gulf Breeze FL 32561-4495 |
| Mailing Address |
Po Box 280 Gulf Breeze Gulf Breeze FL 32562-0280 |
| Practice Telephone | 8509325055 |
| Practice Fax Number | 8509321401 |
| Mailing Telephone | 8509325055 |
| Mailing Fax Number | 8509321401 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2009-03-03 |
| Authorized Official Name | MR. JAMES BEN RENFROE (OWNER) |
| Authorized Official Telephone | 8509325055 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 529918930 | 05 | |
| FL | 257889100 | 05 |
| Street Address |
400 GULF BREEZE PKWY SUITE 300 |
| City | GULF BREEZE |
| State | FL |
| Zip Code | 32561-4495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063414092 | Genei S Bougher | Nurse Practitioner | 400 Gulf Breeze Pkwy, Suite 300, Gulf Breeze, FL 32561-4495 | 2005-08-10 |
| 1548700479 | Lindi Nathaleanne Evers | Nurse Practitioner | 400 Gulf Breeze Pkwy, Suite 204, Gulf Breeze, FL 32561-4495 | 2017-02-25 |
| 1255708681 | Mailande Dedeaux | Physician Assistant | 400 Gulf Breeze Pkwy, Suite 300, Gulf Breeze, FL 32561-4458 | 2015-09-02 |
| 1396135117 | Emerald Coast Pediatric Sleep Consultants, LLC | Nurse Practitioner | 400 Gulf Breeze Pkwy, Suite 204, Gulf Breeze, FL 32561-4495 | 2015-02-01 |
| 1841569357 | Child Neurology Center of Nw Fl Pa | Psychiatry & Neurology | 400 Gulf Breeze Pkwy, Suite 202, Gulf Breeze, FL 32561-4495 | 2011-12-29 |
| 1396915898 | Weldon Arnold Mauney IIi | Specialist | 400 Gulf Breeze Pkwy, Suite 300, Gulf Breeze, FL 32561-4495 | 2008-03-11 |
| 1285794826 | Sonia A Smith | Nurse Practitioner | 400 Gulf Breeze Pkwy, Suite 300, Gulf Breeze, FL 32561-4495 | 2006-12-12 |
| 1861410979 | Tracy A Ezelle | Nurse Practitioner | 400 Gulf Breeze Pkwy, Suite 300, Gulf Breeze, FL 32561-4495 | 2006-07-17 |
| 1780686717 | James Ben Renfroe | Psychiatry & Neurology | 400 Gulf Breeze Pkwy, Ste 300, Gulf Breeze, FL 32561-4495 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700416815 | Susan Carol Bane | Physical Therapist | 1500 Via Deluna, D6, Pensacola Beach, FL 32561 | 2020-01-17 |
| 1174027478 | Aegis Group Practice LLC | Occupational Therapist | 50 Joachim Drive, Gulf Breeze, FL 32561 | 2018-03-21 |
| 1497296081 | Gulf Coast Health System Imaging, LLC | Clinic/Center | 4033 Gulf Breeze Parkway, Gulf Breeze, FL 32561 | 2017-03-15 |
| 1265836233 | Karen Tarvid | Radiologic Technologist | 1390 Fort Pickens Road, 212, Gulf Breeze, FL 32561 | 2014-10-20 |
| 1063825990 | Thomas Ryan Mcpherson | Dentist | 41 Fairpoint Dr Ste A, Gulf Breeze, FL 32561 | 2014-06-09 |
| 1316210974 | White Edward Gibson IIi | Internal Medicine | 408 N. Sunset Blvd., Gulf Breeze, FL 32561 | 2012-02-13 |
| 1467742866 | Katherine Seipel Crawford | Pediatrics | 15 Daniel Dr, Gulf Breeze, FL 32561 | 2011-04-19 |
| 1497067987 | Total Spinal Solutions LLC | Clinic/Center | 1300 Shoreline Drive, Ste. 104, Gulf Breeze, FL 32561 | 2010-07-13 |
| 1528184322 | Bonnie Dansby | Nurse Practitioner | 1600 Via Deluna Drive, E403, Pensacola Beach, FL 32561 | 2007-03-22 |
| 1891841425 | Darby Lynn Godwin | Psychologist | 7 Center Road, Gulf Breeze, FL 32561 | 2007-01-26 |
| Find all providers in zip 32561 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881821395 | Kelly Conlan | Specialist | 1955 Reserve Blvd, Gulf Breeze, FL 32563-7018 | 2009-06-11 |
| 1699841080 | Paradigm Anesthesia Pa | Specialist | 1100 Gulf Breeze Pkwy, Gulf Breeze, FL 32561-4836 | 2006-11-28 |
| 1356358139 | Margaret Vesta Schorghofer | Specialist | 1990 Justice Cir, Gulf Breeze, FL 32563-8664 | 2006-08-02 |
| 1992733869 | Sarah Lewis Wandell | Specialist | 5025 Soundside Dr, Gulf Breeze, FL 32563-8921 | 2006-06-29 |
| 1396915898 | Weldon Arnold Mauney IIi | Specialist | 400 Gulf Breeze Pkwy, Suite 300, Gulf Breeze, FL 32561-4495 | 2008-03-11 |
| 1205046760 | Mccollough Plastic Surgery Clinic | Specialist | 1040 Gulf Breeze Pkwy, Suite 207, Gulf Breeze, FL 32561-4838 | 2007-05-23 |
| 1992847230 | Gulf Coast Orthopedic Specialists | Specialist | 1040 Gulf Breeze Pkwy, Suite 204, Gulf Breeze, FL 32561-4838 | 2007-02-13 |
| 1861585986 | Steven C Kronlage | Specialist | 1040 Gulf Breeze Pkwy, Suite 209, Gulf Breeze, FL 32561-7808 | 2006-10-02 |
| 1649363763 | Robert P Jensen | Specialist | 1040 Gulf Breeze Pkwy, Andrews Institute, Gulf Breeze, FL 32561-7809 | 2006-10-02 |
| 1538252630 | Charles A Roth | Specialist | 1040 Gulf Breeze Pkwy, Suite 200, Gulf Breeze, FL 32561-7809 | 2006-10-02 |
| Find all providers in GULF BREEZE | ||||
| City | GULF BREEZE |
| Zip Code | 32561 |
Please comment or provide details below to improve the information on CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.