EMERALD COAST NEONATOLOGY PA (NPI# 1285726091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285726091 |
| Entity Type | Organization |
| Organization Name | EMERALD COAST NEONATOLOGY PA |
| Practice Address |
4250 Hospital Drive Marianna FL 32446 |
| Mailing Address |
Po Box 15789 Panama City FL 32406 |
| Practice Telephone | 8502659332 |
| Practice Fax Number | 8507847706 |
| Mailing Telephone | 8502659332 |
| Mailing Fax Number | 8507847706 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2009-01-22 |
| Authorized Official Name | DR. DOUGLAS SPRAGUE (PRESIDENT) |
| Authorized Official Telephone | 8502659332 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
ME66820 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS FLORIDA | 45706 | 01 |
| FL | 260912600 | 05 |
| Street Address |
4250 HOSPITAL DRIVE |
| City | MARIANNA |
| State | FL |
| Zip Code | 32446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054817 | Covenant Home Health Care, LLC | Home Health | 4540 Lafayette Street, Ste. G, Marianna, FL 32446 | 2019-07-11 |
| 1063902930 | Syntha Alvarez | Assistant Behavior Analyst | 3217 Highway 71, Marianna, FL 32446 | 2018-05-15 |
| 1922528926 | Charlotte Allen | Respite Care | 4326 Deering Street, Marianna, FL 32446 | 2017-06-21 |
| 1003352097 | Jonathan Lee | Physical Therapist | 4387 Kelson Ave Apt A, Marianna, FL 32446 | 2017-01-13 |
| 1386003192 | Harold B Parker | Nurse Practitioner | Sunland Center 3700 Williams Drive, Marianna, FL 32446 | 2016-02-22 |
| 1912372756 | John Tyler Ellerbee | Nurse Practitioner | 4215 E Kelson Ave, Marianna, FL 32446 | 2015-12-04 |
| 1902206790 | Jason Williams | Spec/Tech, Cardiovascular | 3625 Fci Road, Marianna, FL 32446 | 2014-08-28 |
| 1336558238 | Rocky Mountain Holdings, LLC | Ambulance | 3689 Industrial Park Dr, Marianna, FL 32446 | 2014-08-05 |
| 1831430826 | Jantzen Wayne Whitehead | Counselor | 2860 Highway 71 N, Suite A, Marianna, FL 32446 | 2013-03-15 |
| 1336498047 | Sharon Lynn Miller | Counselor | 2933 Madison Street, Marianna, FL 32446 | 2012-09-10 |
| Find all providers in zip 32446 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114578853 | Erica Stoller | Pediatrics | 1117 E Hallandale Beach Blvd Ste 1, Hallandale Beach, FL 33009-4488 | 2019-09-24 |
| 1629323001 | Hamza Saeed Elkhidir | Pediatrics | 11252 Sw Kingslake Cir, Port St Lucie, FL 34987-2761 | 2012-07-20 |
| 1629331004 | Natalie Victoria Roebuck Bishop | Pediatrics | 1600 S Andrews Ave Fl Picu7, Fort Lauderdale, FL 33316-2510 | 2012-06-20 |
| 1598061574 | Jennifer Christine Munoz Pareja | Pediatrics | 1611 Nw 12th Ave Fl 6006, Miami, FL 33136-1005 | 2011-02-08 |
| 1720382054 | Ricardo A Queiro | Pediatrics | 1421 Sorolla Ave, Coral Gables, FL 33134-3519 | 2010-12-30 |
| 1245534593 | Carmen E Ocampo Benavides | Pediatrics | 1420 Brickell Bay Dr, Apt #907, Miami, FL 33131-3606 | 2010-12-30 |
| 1114044146 | Chad D Scheller | Pediatrics | 3501 Johnson St Dept Of, Hollywood, FL 33021 | 2007-03-23 |
| 1942370416 | Pediatric Hospital Services of Southwest Florida | Pediatrics | 157 Dockside Cir, Weston, FL 33327-1101 | 2006-11-09 |
| 1861577256 | Mark Swanson | Pediatrics | 92 West Miller Street, Orlando, FL 32806 | 2006-10-26 |
| 1841374295 | Enzo Javier Garcia | Pediatrics | 11760 Sw 40th St Ste 722, Miami, FL 33175-8101 | 2006-10-24 |
| Find all providers with the same taxonomy | ||||
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| 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.