Emerald Coast Psychiatric Care PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

53869 Issued in FL

Legal business name

EMERALD COAST PSYCHIATRIC CARE PA

Practice address

124 E Miracle Strip Pkwy
Suite 602
Mary Esther, FL 32569-1988

Phone

(850) 244-0101

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Victor F Demoya, M.D.

Title

President

Phone

(850) 244-0101

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anne Waguespack Berteau, LCSW

  • Clinical Social Worker
  • Navarre, FL
  • NPI 1811006448
  NPD (past)
• Deborah Risher Simkin, M.D.

  • Child & Adolescent Psychiatry Physician
  • Destin, FL
  • NPI 1457477630
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679613962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E MIRACLE STRIP PKWY",
            "address_2": "SUITE 602",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691988",
            "telephone_number": "850-244-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E MIRACLE STRIP PKWY",
            "address_2": "SUITE 602",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691988",
            "telephone_number": "850-244-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST PSYCHIATRIC CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMOYA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-244-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "53869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristian David Edlund, O.D.
• Shanaire Moya Edwards
• Kaitlyn Eigenbrode, RD,LDN
• Rana Elkassih, PA-C
• Emerald Coast Counseling & Associates
• Michelle Espinoza, LMHC
• Leonard William Fabian III, D.C.
• Dina Anne Farmer
• Bradyn Harrison Flanagin
• Florida Kids Ppec, LLC

• Psychiatry Physician in Mary Esther, FL
• Providers in Mary Esther, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.