Emerald Coast Dermatology & Skin Surgery Center PA
NPI 1386639912ActiveOrganization· Dermatology· Crestview, FL
Dermatology in Crestview, Florida, registered in NPPES in September 2005. The authorized official on file is Jillian Owens, Credentialing And Contracting. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1386639912 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 20, 2005 |
| Last updated in NPPES | Sep 25, 2026 |
| Certified by provider | Sep 25, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | ME0061435 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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