Emerald Coast Diabetes & Nutrition Center is a medicare enrolled "General Practice" provider in Fort Walton Beach, Florida. Their current practice location is
115 Miracle Strip Pkwy Se Unit 101, Fort Walton Beach, Florida. You can reach out to their office (for appointments etc.) via phone at
(850) 374-7604.
Emerald Coast Diabetes & Nutrition Center is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Emerald Coast Diabetes & Nutrition Center
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1700307550.
Healthcare Provider's Profile
| Full Name | Emerald Coast Diabetes & Nutrition Center |
|---|
| Type | Facility |
|---|
| Speciality | General Practice |
|---|
| Location | 115 Miracle Strip Pkwy Se Unit 101, Fort Walton Beach, Florida |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1700307550
- Provider Enumeration Date: 07/02/2017
- Last Update Date: 09/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 1456624287
- Enrollment ID: O20170830001343
Medical Identifiers
Medical identifiers for Emerald Coast Diabetes & Nutrition Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1700307550 | NPI | - | NPPES |
| 1J0TM | Other | FL | BCBS |
| ND3885 | Other | FL | FLORIDA LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | ND3885 (Florida) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Emerald Coast Diabetes & Nutrition Center acts as a billing entity for following providers:
| Provider Name | Deanna Howard-gonzalez |
|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
|---|
| Provider Identifiers | NPI Number: 1881823060
PECOS PAC ID: 7517013816
Enrollment ID: I20090928000351 |
|---|
| Provider Name | Rebekah Burns Saar |
|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
|---|
| Provider Identifiers | NPI Number: 1508909193
PECOS PAC ID: 2466898267
Enrollment ID: I20240418002649 |
|---|
| Provider Name | Judith Medina |
|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
|---|
| Provider Identifiers | NPI Number: 1619861952
PECOS PAC ID: 8628589991
Enrollment ID: I20250613001988 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Emerald Coast Diabetes & Nutrition Center is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Emerald Coast Diabetes & Nutrition Center
115 Miracle Strip Pkwy Se Unit 101,
Fort Walton Beach, FL 32548-5976
Ph: (850) 374-7604 | Emerald Coast Diabetes & Nutrition Center
115 Miracle Strip Pkwy Se Unit 101,
Fort Walton Beach, FL 32548-5976
Ph: (850) 374-7604 |
Reviews and Comments