INFECTIOUS DISEASES ASSOCIATES OF NORTHWEST FLORIDA PA
Osteopathic Medicine at 9 Ave, Pensacola, FL

License number
Florida 601606
Category
Osteopathic Medicine
Type
Infectious Disease
Owner
Name: DR. BARBARA H WADE M.D.
Title: OWNER PRESIDENT
Phone: (850) 476-3131
Address
Address
5153 N 9Th Ave SUITE 305, Pensacola, FL 32504
National Provider ID: 1174657332
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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INFECTIOUS DISEASES ASSOCIATES OF NORTHWEST FLORIDA, PA

Pensacola, FL

Status:
Inactive
Inactive reason:
Reinstatement
Registration:
Nov 1, 1993
Inactive since:
Mar 10, 1997
Addresses:
4300 Byu Blvd SUITE 17 B, Pensacola, FL 32503 (Physical)
5153 N 9 Ave, Pensacola, FL 32504
State ID:
P93000076982
Business type:
Florida Profit Corporation
S:
Wade, Barbara H, Dr, 4300 Byu Blvd, Pensacola, FL 32503 (Physical),Barbara H. Wade (Managing Member),Edgardo E. Li-Espino inactive
Agent:
Barbara Wade,4300 Byu Blvd SUITE 17 B, Pensacola, FL 32503 (Physical)
EIN:
593209737

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