PRESTIGE MEDICAL LLC. (NPI# 1770121311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770121311 |
| Entity Type | Organization |
| Organization Name | PRESTIGE MEDICAL LLC. |
| Practice Address |
103 S Navy Blvd Pensacola FL 32507-3603 |
| Practice Telephone | 8503611502 |
| Practice Fax Number | 8503611503 |
| Mailing Telephone | 8503611502 |
| Mailing Fax Number | 8503611503 |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |
| Authorized Official Name | BRIAN NORRIS (OWNER) |
| Authorized Official Telephone | 9853778909 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRESTIGE MEDICAL LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Prestige Medical LLC. | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRESTIGE MEDICAL LLC | 857 Downtowner Blvd Ste G, Mobile, AL 36609-5420 |
| Colorado Business Entities | Prestige Medical LLC | 214 Destini Drive, Fort Collins, CO 80525 |
| Street Address |
103 S NAVY BLVD |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32507-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578766069 | Franklin E. May,dds,pa | Dentist | 103 S Navy Blvd, Pensacola, FL 32507-3603 | 2007-06-11 |
| 1477020337 | Lidia Nenciu | Nurse Practitioner | 103 S Navy Blvd, Pensacola, FL 32507-3603 | 2018-10-30 |
| 1427157510 | Franklin E May | Dentist | 103 S Navy Blvd, Pensacola, FL 32507-3603 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538725163 | Rachel Lynn Cain | Social Worker | Jacc Hudvash C/o Rachel Cain, 790 Veteran's Way, Pensacola, FL 32507 | 2019-05-20 |
| 1710489562 | Erika Ruth Atkins | Developmental Therapist | 14530 Perdido Key Dr., Unit 6, Pensacola, FL 32507 | 2018-03-07 |
| 1013431600 | Megan Wohlers | Optometrist | 12591 Sorrento Rd Ste B, Pensacola, FL 32507 | 2017-07-26 |
| 1568834182 | Kalia Belessis | Behavioral Analyst | 30 S. 3rd Street, Pensacola, FL 32507 | 2015-10-22 |
| 1245677327 | Pensacola Imaging, LLC | Radiology | 12385 Sorrento Road, Suite B1, Pensacola, FL 32507 | 2013-05-29 |
| 1518301696 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5820 West Highway 98, Bldg 3737, Pensacola, FL 32507 | 2013-04-19 |
| 1851528764 | Xin Wei | Internal Medicine | 6000 West Highway 98, Apo, AP 32507 | 2009-06-18 |
| 1205033842 | Lori Lynn Douglass | Day Training, Developmentally Disabled Services | 4711 Huron Dr, Pensacola, FL 32507 | 2007-06-28 |
| 1346461985 | Jennifer Ann Sculley | Pharmacist | 13019 Sorrento Road, Pensacola, FL 32507 | 2007-05-01 |
| 1528183704 | Al M Ridlehoover | Dentist | 302 W Sunset Ave, Pensacola, FL 32507 | 2007-03-20 |
| Find all providers in zip 32507 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1326094848 | Sacred Heart Hospital On The Emerald Coast | Clinic/Center | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2006-05-26 |
| 1568452688 | West Florida Medical Center Clinic, Pa | Clinic/Center | 8333 N Davis Hwy, Pensacola, FL 32514-6050 | 2005-10-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.