LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC (NPI# 1508854571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508854571 |
| Entity Type | Organization |
| Organization Name | LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC |
| Practice Address |
525 East 15th Street Panama City FL 32405-0000 |
| Mailing Address |
525 E 15th St Panama City FL 32405-5412 |
| Practice Telephone | 8505224485 |
| Practice Fax Number | 8509146281 |
| Mailing Telephone | 8505224485 |
| Mailing Fax Number | 8509146281 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2016-11-23 |
| Authorized Official Name | MR. EDWIN AILES (CEO/PRESIDENT) |
| Authorized Official Telephone | 8505224485 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 060296500 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 99260 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861422099 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 801 S Weeks St, Bonifay, FL 32425-3046 | 2006-07-04 |
| 1659301877 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 16869 Ne Pear St, Blountstown, FL 32424-1774 | 2006-07-04 |
| 1003022369 | Life Management Center of Northwest Florida Inc | Community/Behavioral Health | 525 E 15th St, Panama City, FL 32405-5412 | 2007-05-15 |
| 1467487876 | Life Management Center of Northwest Florida Inc | Counselor | 525 E 15th St, Panama City, FL 32405-5412 | 2006-07-12 |
| 1710912886 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 310 E Byrd Ave, Bonifay, FL 32425-3006 | 2006-07-11 |
| 1316977515 | Life Management Center of Northwest Florida Inc | Clinic/Center | 311 Williams Ave, Port St Joe, FL 32456-1845 | 2006-07-04 |
| 1255367579 | Life Management Center of Northwest Florida Inc | Psychiatry & Neurology | 4094 Lafayette St, Marianna, FL 32446-5648 | 2006-06-26 |
| Street Address |
525 EAST 15TH STREET |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32405-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962136 | Kimberlea Fox | Behavioral Analyst | 4750 Collegiate Drive, Technology Building 157, Panama City, FL 32405 | 2020-08-14 |
| 1598325714 | Covenant Home Health Care, LLC | Home Health | 107 W. 19th Street, Panama City, FL 32405 | 2019-06-19 |
| 1467921403 | Amy Hancock | Counselor | 1212 W. 19th St., Panama City, FL 32405 | 2018-11-20 |
| 1063991917 | Patricia Kagendo Mutunga | Day Training, Developmentally Disabled Services | 2813 Fairmont Dr, Panama City, FL 32405 | 2018-08-11 |
| 1871087882 | Southeastern Dermatology Group Pa | Pharmacy | 2505 Harrison Ave Ste A, Panama City, FL 32405 | 2018-06-22 |
| 1346733615 | Jessica Nicole Graham | Nurse Practitioner | 2507 Harrison Ave Unit 101, Panama City, FL 32405 | 2018-06-12 |
| 1437658424 | Coastal Mobility Transportation, LLC | Non-emergency Medical Transport (VAN) | 203 Forest Park Circle, Panama City, FL 32405 | 2018-02-06 |
| 1003314915 | The Anti-aging Clinic of Northwest Florida | Obstetrics & Gynecology | 3019 Osprey Cir, Panama City, FL 32405 | 2018-01-25 |
| 1255848487 | Sarah Theriot | Social Worker | 700 W 23rd St Bldg H, Panama City, FL 32405 | 2018-01-09 |
| 1336686054 | Angela Leake | Registered Nurse | 449 W 23 St, Panama City, FL 32405 | 2017-01-20 |
| Find all providers in zip 32405 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245501378 | Edward D. Gibson Jr Md Pa | Psychiatry & Neurology | 1514 W 23rd St Ste A-4, Panama City, FL 32405-2905 | 2012-01-20 |
| 1386837961 | John Terry Renick | Psychiatry & Neurology | 1108 Clay Ave, Panama City, FL 32401-1673 | 2007-08-27 |
| 1427159516 | Paul Jon Gitlin | Psychiatry & Neurology | 525 E 15th Street, Panama City, FL 32405-5412 | 2006-09-25 |
| 1205885753 | John Roy Billingsley | Psychiatry & Neurology | 102 Springhill Cir, Panama City, FL 32405-3546 | 2006-05-10 |
| 1962489484 | Luis N Zumarraga | Psychiatry & Neurology | 2003 Wilson Ave, Panama City, FL 32405-4532 | 2005-12-27 |
| 1760482509 | Gary D Gorman | Psychiatry & Neurology | 217 Forest Park Cir, Panama City, FL 32405-4916 | 2005-07-22 |
| 1366448615 | Paul H Wurst | Psychiatry & Neurology | 525 E 15th St, Panama City, FL 32405-5412 | 2005-06-22 |
| 1427051937 | Paul Kenneth Phillips | Psychiatry & Neurology | 1940 Harrison Ave, Panama City, FL 32405-4542 | 2005-05-30 |
| 1134530660 | Royce Paul Gray | Psychiatry & Neurology | 1940 Harrison Ave, Panama City, FL 32405 | 2014-05-19 |
| 1245664531 | Walter David Smith | Psychiatry & Neurology | 1940 Harrison Ave, Panama City, FL 32405-4542 | 2013-08-22 |
| Find all providers in PANAMA CITY | ||||
| City | PANAMA CITY |
| Zip Code | 32405 |
Please comment or provide details below to improve the information on LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC.
| 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.