| Foundations Medical Center Pllc | |
|
4467 Commons Dr W Ste F-g Destin FL 32541-8454 | |
| (850) 269-9000 | |
| (850) 269-9002 |
| Full Name | Foundations Medical Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4467 Commons Dr W Ste F-g, Destin, Florida |
| Authorized Official Name and Position | Kyle S Chavers (OWNER) |
| Authorized Official Contact | 8502699000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Medical Center Pllc 4467 Commons Dr W Ste F-g Destin FL 32541-8454 Ph: (850) 269-9000 | Foundations Medical Center Pllc 4467 Commons Dr W Ste F-g Destin FL 32541-8454 Ph: (850) 269-9000 |
| NPI Number | 1811598105 |
|---|---|
| Provider Enumeration Date | 11/04/2020 |
| Last Update Date | 11/04/2020 |
| Medicare PECOS PAC ID | 2961814470 |
|---|---|
| Medicare Enrollment ID | O20201207001600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811598105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
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