North Okaloosa Clinic Corp

NPI #1154994697 in Crestview, Florida

Provider Information

NPI Number: 1154994697
Entity Type: Organization
Organization Name: North Okaloosa Clinic Corp
Primary Specialty: General Practice
Enumeration Date: Jul 22, 2021
Last Updated: Mar 18, 2022

Practice Location

Address: 1332 N FERDON BLVD
City: Crestview
State: Florida
ZIP Code: 32536-1749
Phone: (850) 398-8725

Authorized Official

Name: JENNIFER L JACKSON
Title: SR DIR PROV ENROLLMENT & ONBOARDING
Phone: (615) 465-3334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
General Practice	208D00000X	Primary

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Individual Providers

Provider Name	Specialty	City
DR. Luis Angel Lopezrivera, M.D.	General Practice	Crestview	AI Deep Dive
DR. Pedro D Rivera Morillo, M.D.	General Practice	Middleburg	AI Deep Dive
Bogdan F Maliszewski, MD	General Practice	Mayo	AI Deep Dive

Organizations

Provider Name	Specialty	City
Marcene F. Kreifels, M.d., P.a.	General Practice	Crestview	AI Deep Dive
North Okaloosa Clinic Corp	General Practice	Crestview	AI Deep Dive

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