Organization · Type 2 NPI

Emerald Coast Infectious Diseases Medical Group, PA

Community/Retail Pharmacy · Fort Walton Beach, FL

NPI number 1154773950 Active

Practice location

917 Mar Walt Drive, Suite D
Fort Walton Beach, FL 32547

Call (850) 312-3570 Map

Fax (850) 312-3090

Mailing address

1620 W. Northwest Hwy, Suite 100
Grapevine, TX 76051

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	PH30219 (FL)
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1154773950
Entity type: Organization (Type 2)
Issued: Jul 6, 2016
Last updated: Mar 3, 2025
Status: Active
Subpart: Yes of Emerald Coast Infectious Diseases

Other names

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Synergy Specialty Pharmacy · doing business as
Synergy Specialty Pharmacy · doing business as

Authorized official

Mr. Eric Squatrito
Vice President of Operations
(724) 977-8498

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1154773950

Emerald Coast Infectious Diseases Medical Group, PA's National Provider Identifier is 1154773950, issued on Jul 6, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Fort Walton Beach, FL. The record was last updated on Mar 3, 2025.