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RADIANCE OF THE EMERALD COAST
NPI 1962803759
Specialist in Fort Walton Beach, FL

Active since September 11, 2014
348 MIRACLE STRIP PKWY SW STE 15, FORT WALTON BEACH, FL 32548(850) 586-7661 Get Directions Write a Review

NPPES record last updated: September 11, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Radiance Of The Emerald Coast NPPES

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

RADIANCE OF THE EMERALD COAST (NPI 1962803759) is a healthcare organization registered as a specialist in Fort Walton Beach, Florida and active in the NPI registry since September 2014. The organization lists Candace Cooley, Physician, as its authorized official.

NPPES Registry Identity

NPI1962803759
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameRADIANCE OF THE EMERALD COAST
Location Address348 MIRACLE STRIP PKWY SW STE 15Fort Walton Beach, FL 32548-5258
Mailing Address348 Miracle Strip Pkwy Sw Ste 15Fort Walton Beach, FL 32548-5258 · (850) 586-7661
Phone(850) 586-7661
Organization SubpartNo
Authorized OfficialCandace CooleyPhysician · (850) 586-7661
Enumeration DateSeptember 11, 2014
✔ NPI 1962803759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ME77965
Definition
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.
348 MIRACLE STRIP PKWY SW STE 15, Fort Walton Beach, FL 32548
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Radiance Of The Emerald Coast's NPI number?

The NPI number for Radiance Of The Emerald Coast is 1962803759. It was assigned to this organization in the NPPES registry on September 11, 2014.

Where is Radiance Of The Emerald Coast located?

Radiance Of The Emerald Coast is located at 348 Miracle Strip Pkwy SW Ste 15, Fort Walton Beach, FL 32548. The listed phone number is (850) 586-7661.

What is Radiance Of The Emerald Coast's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Radiance Of The Emerald Coast was last updated on September 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.