EMERALD COAST DIABETES & NUTRITION CENTER
NPI 1700307550
General Practice in Fort Walton Beach, FL

Active since July 02, 2017
115 MIRACLE STRIP PKWY SE UNIT 101, FORT WALTON BEACH, FL 32548(850) 374-7604(850) 792-2545 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 13, 2022, May 9, 2018, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

About Emerald Coast Diabetes & Nutrition Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMERALD COAST DIABETES & NUTRITION CENTER (NPI 1700307550) is a healthcare organization registered as a general practice in Fort Walton Beach, Florida and active in the NPI registry since July 2017. The organization maintains a secondary practice location in Crestview and lists Deanna Howard-gonzalez, Owner, as its authorized official.

NPPES Registry Identity

NPI1700307550
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameEMERALD COAST DIABETES & NUTRITION CENTER
Location Address115 MIRACLE STRIP PKWY SE UNIT 101Fort Walton Beach, FL 32548-5976
Mailing Address115 Miracle Strip Pkwy Se Unit 101Fort Walton Beach, FL 32548-5976 · (850) 374-7604 · Fax (850) 792-2545
Fax(850) 792-2545
Organization SubpartNo
Authorized OfficialDeanna Howard-gonzalezOwner · (850) 374-7604
Enumeration DateJuly 2, 2017
Last NPPES UpdateSeptember 13, 20224 updates tracked since enumeration
NPPES CertifiedSeptember 13, 2022
NPI 1700307550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedDietitian, RegisteredTaxonomy 133V00000X · License ND3885 (FL)
115 MIRACLE STRIP PKWY SE UNIT 101, Fort Walton Beach, FL 32548

Secondary Practice Location 1

Location 1951 S Ferdon BlvdCrestview, FL 32536-4507 · Phone (850) 374-7604 · Fax (850) 792-2545

Other Identifiers 2

Other1J0TMFL · Bcbs
OtherND3885FL · Florida License

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dietitian, Registered
115 MIRACLE STRIP PKWY SE UNIT 101
FORT WALTON BEACH, FL 32548

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emerald Coast Diabetes & Nutrition Center's NPI number?

The NPI number for Emerald Coast Diabetes & Nutrition Center is 1700307550. It was assigned to this organization in the NPPES registry on July 2, 2017.

Where is Emerald Coast Diabetes & Nutrition Center located?

Emerald Coast Diabetes & Nutrition Center is located at 115 Miracle Strip Pkwy SE Unit 101, Fort Walton Beach, FL 32548. The listed phone number is (850) 374-7604.

What is Emerald Coast Diabetes & Nutrition Center's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Emerald Coast Diabetes & Nutrition Center was last updated on September 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.