| Gulf Coast Mobile Medical Care Llc | |
|
471 Fort Pickens Rd Pensacola Beach FL 32561-2013 | |
| (850) 462-3131 | |
| (877) 370-4373 |
| Full Name | Gulf Coast Mobile Medical Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 471 Fort Pickens Rd, Pensacola Beach, Florida |
| Authorized Official Name and Position | Jake Wallstedt (PARTNER) |
| Authorized Official Contact | 6155176009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Mobile Medical Care Llc 471 Fort Pickens Rd Gulf Breeze FL 32561-2013 Ph: () - | Gulf Coast Mobile Medical Care Llc 471 Fort Pickens Rd Pensacola Beach FL 32561-2013 Ph: (850) 462-3131 |
| NPI Number | 1689330854 |
|---|---|
| Provider Enumeration Date | 11/12/2021 |
| Last Update Date | 02/23/2023 |
| Medicare PECOS PAC ID | 0446642813 |
|---|---|
| Medicare Enrollment ID | O20220114000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689330854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Elizabeth A Townley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649205659 PECOS PAC ID: 4789785403 Enrollment ID: I20070725000480 |
| Provider Name | Clyde J Patroni |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851584346 PECOS PAC ID: 3779657481 Enrollment ID: I20080729000635 |
| Provider Name | Shea Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063829315 PECOS PAC ID: 8224351143 Enrollment ID: I20160321000898 |
| Provider Name | Dolores Anne Holtmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659777985 PECOS PAC ID: 3678892767 Enrollment ID: I20181023001990 |
| Provider Name | Julia Marie Maclay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114582228 PECOS PAC ID: 5991032815 Enrollment ID: I20190814002917 |
| Provider Name | Brooke Ann Kessinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407516040 PECOS PAC ID: 5698167930 Enrollment ID: I20220119001880 |
| Provider Name | Bonnie Duce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457008997 PECOS PAC ID: 0840686689 Enrollment ID: I20220405000602 |
| Provider Name | Elizabeth Beaty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699491498 PECOS PAC ID: 3870960917 Enrollment ID: I20221102003452 |