| Emerald Coast Rheumatology Llc | |
|
3890 Jenks Ave Lynn Haven FL 32444-4701 | |
| (850) 215-6400 | |
| (850) 215-4440 |
| Full Name | Emerald Coast Rheumatology Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3890 Jenks Ave, Lynn Haven, Florida |
| Authorized Official Name and Position | Aymen A. Kenawy (CEO / MEDICAL DIRECTOR) |
| Authorized Official Contact | 8502156400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Rheumatology Llc 3890 Jenks Ave Lynn Haven FL 32444-4701 Ph: (850) 215-6400 | Emerald Coast Rheumatology Llc 3890 Jenks Ave Lynn Haven FL 32444-4701 Ph: (850) 215-6400 |
| NPI Number | 1427346469 |
|---|---|
| Provider Enumeration Date | 07/12/2011 |
| Last Update Date | 03/18/2025 |
| Medicare PECOS PAC ID | 7810165206 |
|---|---|
| Medicare Enrollment ID | O20110801000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427346469 | NPI | - | NPPES |
| Provider Name | Aymen A Kenawy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1770780603 PECOS PAC ID: 5991973380 Enrollment ID: I20110801000254 |
| Provider Name | Shawntell S World |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659786283 PECOS PAC ID: 8729390752 Enrollment ID: I20150706001822 |
| Provider Name | Eugene R Jalbert |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1316372816 PECOS PAC ID: 6507173028 Enrollment ID: I20150916001517 |
| Provider Name | Stephen W Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679924716 PECOS PAC ID: 6800176447 Enrollment ID: I20161216001709 |
| Provider Name | Amanda Marie Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033577374 PECOS PAC ID: 5092071308 Enrollment ID: I20171101003502 |
| Provider Name | Bilal Islam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124361431 PECOS PAC ID: 7113205139 Enrollment ID: I20190128001258 |
| Provider Name | Samantha Avla Blue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942729090 PECOS PAC ID: 9931447307 Enrollment ID: I20190208002849 |
| Provider Name | Yusra Moursy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023468840 PECOS PAC ID: 8123312659 Enrollment ID: I20201006000991 |
| Provider Name | Andrew Christopher Rising |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578194544 PECOS PAC ID: 6204247349 Enrollment ID: I20201123000525 |
| Provider Name | Michelle Satterfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841859303 PECOS PAC ID: 2163758392 Enrollment ID: I20210308000812 |
| Provider Name | Camile A Shamblin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639760457 PECOS PAC ID: 1254747413 Enrollment ID: I20210312001148 |
| Provider Name | Ashely A Ferrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386215085 PECOS PAC ID: 2769886209 Enrollment ID: I20210805003052 |
| Provider Name | Tanya Hodgens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821013491 PECOS PAC ID: 0244269728 Enrollment ID: I20220323002305 |
| Provider Name | Brynn Ledman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588343776 PECOS PAC ID: 0648633198 Enrollment ID: I20230830003619 |
| Provider Name | Jennifer M Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528461902 PECOS PAC ID: 8325417397 Enrollment ID: I20230913001747 |
| Provider Name | Jasmine E Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083315170 PECOS PAC ID: 7012450596 Enrollment ID: I20240625002820 |
| Provider Name | Rachel Dowis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376388140 PECOS PAC ID: 4688118466 Enrollment ID: I20240703002669 |
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