RADIANCE OF THE EMERALD COAST (NPI# 1962803759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962803759 |
| Entity Type | Organization |
| Organization Name | RADIANCE OF THE EMERALD COAST |
| Practice Address |
348 Miracle Strip Pkwy Sw Ste 15 Fort Walton Beach FL 32548-5258 |
| Practice Telephone | 8505867661 |
| Mailing Telephone | 8505867661 |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |
| Authorized Official Name | DR. CANDACE COOLEY (PHYSICIAN) |
| Authorized Official Telephone | 8505867661 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ME77965 | FL | Other Service Providers |
| Street Address |
348 MIRACLE STRIP PKWY SW STE 15 |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32548-5258 |
| 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 | 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 |
|---|---|---|---|---|
| 1255849071 | Kerri Lynne Barone | Specialist | 341 Holmes Blvd Nw, Fort Walton Beach, FL 32548-4150 | 2018-01-15 |
| 1922465483 | Krista Maria Fylak | Specialist | 381 Santa Rosa Blvd Unit C708, Fort Walton Beach, FL 32548-3112 | 2016-01-28 |
| 1215303557 | Gregory Helton | Specialist | 22 Beal Pkwy Sw, Fort Walton Beach, FL 32548-5388 | 2015-08-20 |
| 1336381375 | Christie Michele Morgan | Specialist | 205 Priscilla Dr, Suite 307, Fort Walton Beach, FL 32547-3225 | 2009-04-06 |
| 1740384254 | Kerri Morris | Specialist | 24 Hollywood Blvd., Suite 7, Fort Walton Beach, FL 32548 | 2006-09-13 |
| 1821043811 | Basil D. Fossum | Specialist | 914b Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2006-05-24 |
| 1669447199 | Amit Patel | Specialist | 1032 Mar Walt Dr Unit 230, Fort Walton Beach, FL 32547-6661 | 2006-02-20 |
| 1417931585 | Jane A Pratt | Specialist | 219 Crewilla Dr Nw, Fort Walton Beach, FL 32548-3947 | 2005-12-02 |
| 1619979937 | Frank C Zondlo | Specialist | 999 Mar Walt Dr, Fort Walton Beach, FL 32547-6758 | 2005-06-01 |
| 1477806891 | Mary Susan Leger | Specialist | 119 Truxton Ave, Fort Walton Beach, FL 32547-2460 | 2012-10-23 |
| Find all providers in FORT WALTON BEACH | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32548 |
Please comment or provide details below to improve the information on RADIANCE OF THE EMERALD COAST.
| 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.