| Gulf Coast Immediate Care Center Inc. | |
|
345 Miracle Strip Pkwy Sw Fort Walton Beach FL 32548-5210 | |
| (850) 244-3211 | |
| (850) 243-1992 |
| Full Name | Gulf Coast Immediate Care Center Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 345 Miracle Strip Pkwy Sw, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Robert V Siegel (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 8502443211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Immediate Care Center Inc. 345 Miracle Strip Pkwy Sw Fort Walton Beach FL 32548-5210 Ph: (850) 244-3211 | Gulf Coast Immediate Care Center Inc. 345 Miracle Strip Pkwy Sw Fort Walton Beach FL 32548-5210 Ph: (850) 244-3211 |
| NPI Number | 1437113057 |
|---|---|
| Provider Enumeration Date | 04/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9638172745 |
|---|---|
| Medicare Enrollment ID | O20061018000156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437113057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0602460 (Florida) | Primary |
| Provider Name | Robert Varner Siegel |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346202686 PECOS PAC ID: 1850399809 Enrollment ID: I20101015000710 |
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