Everest Healthcare Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EVEREST HEALTHCARE INC

Doing business as

Florida Medical Lab

Practice address

224 Eglin Pkwy NE Ste E
Fort Walton Beach, FL 32547-2877

Phone

(850) 215-4856

Fax

(877) 544-6997

NPI assigned

Aug 13, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Semir Ajsic

Title

Credentialing Specialist

Phone

(704) 904-2862

Specialties & licenses 1

Addresses

Other names 1

• Florida Medical Lab Doing business as

Locations

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1528679586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 BACK CREEK DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282132159",
            "telephone_number": "704-904-2862",
            "fax_number": "704-716-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 EGLIN PKWY NE STE E",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325472877",
            "telephone_number": "850-215-4856",
            "fax_number": "877-544-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVEREST HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "AJSIC",
        "authorized_official_first_name": "SEMIR",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "704-904-2862",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Medical Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Alan Erickson, MD
• Samantha Ervin, APRN
• Tracie Esmond, LCSW
• Amy C Espy, MS,CCC-SLP
• Joseph J Esquibel, MD
• Mary Anne Evertz Wilcox
• Victoria Katelyn Ewing, M.S. CCC-SLP
• Eye Candy Optical LLC
• Eyeglass World
• Amanda Bernadette Eyer, MSN, ARNP FNP-C

• Clinical Medical Laboratory in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.