Emerald Coast Surgical Specialists PA

NPI #1750565768 in Milton, Florida

Provider Information

NPI Number: 1750565768
Entity Type: Organization
Organization Name: Emerald Coast Surgical Specialists PA
Primary Specialty: Surgery
Enumeration Date: Dec 27, 2007
Last Updated: May 30, 2008

Practice Location

Address: 5992 BERRYHILL ROAD
Address 2: 203
City: Milton
State: Florida
ZIP Code: 32570
Phone: (850) 626-2131

Authorized Official

Name: RANDALL L MCKISSACK, MD
Title: OWNER/PHYSICIAN
Phone: (850) 626-2131

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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