Perdido Bay Family Care, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PERDIDO BAY FAMILY CARE, LLC

Practice address

10 Doug Ford Drive
Pensacola, FL 32507-4307

Phone

(850) 492-2010

Fax

(850) 492-2012

NPI assigned

Jan 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Mitchell Lee, M.D.

Title

Physician Owner

Phone

(850) 492-2010

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1174709489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34307",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325074307",
            "telephone_number": "850-492-2010",
            "fax_number": "850-492-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DOUG FORD DRIVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325074307",
            "telephone_number": "850-492-2010",
            "fax_number": "850-492-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERDIDO BAY FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "850-492-2010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "K5362",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• John Angelo Perciballi, M.D.
• Perdido Bay Dental PA
• Perdido Counseling Professionals, Inc.
• Perdido Dental Associates, PA
• Ruben Jesus Perdomo, CRNA
• Amanda Perdue, APRN, FNP-BC
• Elizabeth Pereira, PT, DPT

• Family Medicine Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.