Organization · Type 2 NPI

Radiance of the Emerald Coast

Specialist · Fort Walton Beach, FL

NPI number 1962803759 Active

Practice location

348 Miracle Strip Pkwy SW Ste 15
Fort Walton Beach, FL 32548-5258

Call (850) 586-7661 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XME77965 (FL)

Specialist: 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.

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About NPI 1962803759

Radiance of the Emerald Coast's National Provider Identifier is 1962803759, issued on Sep 11, 2014. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Fort Walton Beach, FL. The record was last updated on Sep 11, 2014.