EMERALD COAST PAIN SERVICES
NPI 1619269180
Specialist in Destin, FL
- Organization
- Specialist
- CLIA Number: 10D2019839
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-28-2027
About EMERALD COAST PAIN SERVICES
This page provides the complete NPI Profile along with additional information for Emerald Coast Pain Services, a provider established in Destin, Florida operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1619269180 assigned on May 2011. The practitioner's primary taxonomy code is 174400000X with license number ME0068957 (FL). The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Emerald Coast Pain Services. The authorized official of this NPI record is Ms. Angela Marie King (Office Manager)
- NPI
- 1619269180 Verify this NPI
- Provider Legal Name
- ANESTHESIA INC
- Other Organization Name
- EMERALD COAST PAIN SERVICES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3997 COMMONS DR W SUITE M DESTIN, FL 32541
- Location Phone
- (850) 424-3769
- Location Fax
- (850) 460-2491
- Mailing Address
- 3997 COMMONS DR W SUITE M DESTIN, FL 32541
- Mailing Phone
- (850) 424-3769
- Mailing Fax
- (850) 460-2491
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-03-2011
- Last Update Date
- 06-10-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- ME0068957
- License State
- FL
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2019839
- Facility Type
- Physician Office
- Certificate Effective Date
- October 29, 2025
- Certificate Expiration Date
- October 28, 2027
- Laboratory Director
- SCOTT HAUFE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Emerald Coast Pain Services to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
DESTIN, FL 32541
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619269180, enumerated as an "organization" on May 03, 2011.
The provider is located at 3997 COMMONS DR W SUITE M DESTIN, FL 32541 and the phone number is (850) 424-3769.
Specialist with taxonomy code 174400000X.
