NPIMap

Organization Active NPI

Pancare of Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, FL
National Provider Identifier
1275346108
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PANCARE OF FLORIDA, INC
Practice address
11033 NW State Road 20
Bristol, FL 32321-6406
Phone
(850) 643-1155
Fax
(850) 643-1163
NPI assigned
Jan 27, 2025
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Laura Riley
Title
Billing Manager
Phone
(850) 215-3578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

11033 NW State Road 20
Bristol, FL 32321-6406

Mailing address

403 E 11TH St
Panama City, FL 32401-3409
Phone (850) 747-5599

Other names 1

  • PANCARE HEALTH BRISTOL Other name

National Provider Directory

National Provider Directory
Tax ID family
Pancare of Florida Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

11033 NW State Road 20
Bristol, FL 32321
Phone (850) 643-1155

Practitioners & affiliated clinicians

Practitioners 77

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1275346108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 11TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013409",
            "telephone_number": "850-747-5599",
            "fax_number": "850-872-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11033 NW STATE ROAD 20",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323216406",
            "telephone_number": "850-643-1155",
            "fax_number": "850-643-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANCARE OF FLORIDA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "850-215-3578"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PANCARE HEALTH BRISTOL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bristol, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.