Emerald Coast Dermatology & Skin Surgery Center P a

NPI #1386639912 in Crestview, Florida

Provider Information

NPI Number: 1386639912
Entity Type: Organization
Organization Name: Emerald Coast Dermatology & Skin Surgery Center P a
Primary Specialty: Dermatology
Enumeration Date: Sep 20, 2005
Last Updated: Jan 20, 2026

Practice Location

Address: 350 REDSTONE AVE W
City: Crestview
State: Florida
ZIP Code: 32536-6433
Phone: (850) 689-1740

Authorized Official

Name: JILLIAN OWENS
Title: CREDENTIALING AND CONTRACTING
Phone: (850) 689-1740

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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