EMERALD COAST INTERNAL MEDICINE AND GERIATRICS LLC
Osteopathic Medicine at Forest Park Cir, Panama City, FL

License number
Florida ME114732
Category
Osteopathic Medicine
Type
Geriatric Medicine
Owner
Name: DR. EMAD A EISA M.D.
Title: MEDICAL DOCTOR
Phone: (703) 598-6013
Address
Address 2
280 Forest Park Cir, Panama City, FL 32405
PO Box 419, Lynn Haven, FL 32444
National Provider ID: 1114339074
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EMERALD COAST INTERNAL MEDICINE AND GERIATRICS, LLC

Panama City, FL  -  Lynn Haven, FL

Registration:
May 13, 2014
Addresses:
280 Frst Park Cir, Panama City, FL 32405 (Physical)
Lynn Haven, FL 32444 (Mailing)
PO Box 419, Lynn Haven, FL 32444
1704 Baldwin Rowe Cir, Panama City, FL 32405
State ID:
L14000077083
Business type:
Florida Limited Liability Company
S:
Eisa, Emad A, Dr, 280 Frst Park Cir, Panama City, FL 32405 (Physical),Emad A. Eisa
Agent:
Emad Eisa,280 Frst Park Cir, Panama City, FL 32405 (Physical)
EIN:
46-5643114

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