1760439319 NPI number — WEST FLORIDA REGIONAL MEDICAL CENTER INC

Table of content: MRS. JACQUELINE LEE GUESS APN (NPI 1891717914)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760439319 NPI number — WEST FLORIDA REGIONAL MEDICAL CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST FLORIDA REGIONAL MEDICAL CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WEST FLORIDA HOSPITAL PHYSICIAN SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760439319
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 17300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32522-7300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-494-5403
Provider Business Mailing Address Fax Number:
850-494-4910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8383 N DAVIS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENSACOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32514-6039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-494-5403
Provider Business Practice Location Address Fax Number:
850-494-4910
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUTLER
Authorized Official First Name:
RANDY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
850-494-4125

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com