GULF COAST IMMEDIATE CARE CENTER INC. (NPI# 1437113057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437113057 |
| Entity Type | Organization |
| Organization Name | GULF COAST IMMEDIATE CARE CENTER INC. |
| Practice Address |
345 Miracle Strip Pkwy Sw Fort Walton Beach FL 32548-5210 |
| Practice Telephone | 8502443211 |
| Practice Fax Number | 8502431992 |
| Mailing Telephone | 8502443211 |
| Mailing Fax Number | 8502431992 |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT V SIEGEL (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Telephone | 8502443211 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
0602460 | FL | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GULF COAST IMMEDIATE CARE CENTER INC | 345 Miracle Strip Parkway Sw, Fort Walton Beach, FL 32548-5210 |
| Street Address |
345 MIRACLE STRIP PKWY SW |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32548-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346202686 | Robert V. Siegel | Family Medicine | 345 Miracle Strip Pkwy Sw, Fort Walton Beach, FL 32548-5210 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718426 | Erica Darby | Pharmacist | Publix, 421 Mary Esther Cut Off, Fort Walton Beach, FL 32548 | 2020-07-30 |
| 1770136681 | Michael Cody Jones | Pharmacist | 251 Miacle Strip Pkwy Se, Fort Walton Beach, FL 32548 | 2019-07-19 |
| 1346714532 | Alison Ann Gould | Occupational Therapy Assistant | Emerald Coast Heath Care, 114 Third St, Fort Walton Beach, FL 32548 | 2019-01-22 |
| 1699217695 | Mayra Lopez | Dentist | Blvd. Gomez Morin #8569, Suite 6a, Juarez, CHIHUAHUA 32548 | 2016-11-08 |
| 1265808455 | Rajiv Tuladhar Dmd Holdings, Pllc | Dentist | 516 Mary Esther Blvd Ste 2, Fort Walton Beach, FL 32548 | 2015-08-11 |
| 1881090702 | Annette Peadro | Behavioral Analyst | 171 Brooks St, Suite 308, Fort Walton Beach, FL 32548 | 2014-11-05 |
| 1790037729 | Julie Bradfield | Counselor | 44 Shell Ave, Fort Walton Beach, FL 32548 | 2012-10-15 |
| 1740559582 | Beth Paula Ritenour | Pharmacist | 414 Mary Esther Cutoff Nw, C, Fort Walton Beach, FL 32548 | 2011-12-23 |
| 1891080867 | Okaloosa County Council On Aging | Home Health | 207 Hospital Drive, Fort Walton Beach, FL 32548 | 2011-06-17 |
| 1649580275 | Sharon Renee Wise | Counselor | 44 Shell Avenue Se, Fort Walton Beach, FL 32548 | 2010-10-17 |
| Find all providers in zip 32548 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386042703 | Quality Primary Care Pllc | Clinic/Center | 514 Mary Esther Cut Off Nw, Fort Walton Beach, FL 32548-4025 | 2014-12-17 |
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| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32548 |
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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.