Unknown Individual – Family Medicine Physician, NPI 1194705160
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1354 COUNTRY CLUB DRIVE
GULF BREEZE, FL 325633471
Phone: (850) 916-1636
Fax: (850) 916-1350
Mailing address matches the actual address.
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)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32563)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | FL | 20610 | Aspiration and/or injection of large joint or joint capsule | 31 | 26 |
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