Provider Demographics
NPI:1487954665
Name:EMERALD COAST FAMILY MEDICINE
Entity type:Organization
Organization Name:EMERALD COAST FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDERS
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-230-2700
Mailing Address - Street 1:22901 PANAMA CITY BEACH PKWY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-1157
Mailing Address - Country:US
Mailing Address - Phone:850-230-2700
Mailing Address - Fax:850-230-2725
Practice Address - Street 1:22901 PANAMA CITY BEACH PKWY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-1157
Practice Address - Country:US
Practice Address - Phone:850-230-2700
Practice Address - Fax:850-230-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101137261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1255316279OtherNPI NUMBER