Unknown Individual – Physician Assistant, NPI 1104078435
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1311, Kentucky Avenue, Lynn Haven, Bay County, Florida, 32444, United States
LYNN HAVEN, FL 324442250
Phone: (850) 814-4778
Type: Mailing
2114, Airport Boulevard, Elite Plaza, Pensacola, Escambia County, Florida, 32504, United States
SUITE 1900
PENSACOLA, FL 325049075
Phone: (850) 471-7020
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32444)
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