Child Neurology Center of Northwest Florida PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA

Practice address

12815 US Highway 98 W Ste 116
Miramar Beach, FL 32550-3245

Phone

(850) 932-5055

Fax

(850) 932-1404

NPI assigned

Jan 17, 2025

Organization subpart

Yes

Parent organization

CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PAAs reported in NPPES

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

Authorized official

Name

James Ben Renfroe, MD

Title

President

Phone

(850) 932-5055

Specialties & licenses 2

Addresses

Tax ID family

Child Neurology Center of Northwest Florida PA2 organizations share this tax ID, including this one

Part of

Child Neurology Center of Northwest Florida PA

Other organizations with this tax ID 1

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

• Child Neurology Center of NW FL PA

  • Neurology with Special Qualifications in Child Neurology Physician
  • Gulf Breeze, FL
  • NPI 1841569357
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Child Neurology Center of Northwest Florida PA

  • General Practice Physician
  • Gulf Breeze, FL
  • NPI 1053392233
  NPPES parent name

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1760293872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325620280",
            "telephone_number": "850-932-5055",
            "fax_number": "850-932-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 US HIGHWAY 98 W STE 116",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325503245",
            "telephone_number": "850-932-5055",
            "fax_number": "850-932-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILD NEUROLOGY CENTER OF NORTHWEST FLORIDA PA",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "RENFROE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-932-5055",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Miramar Beach, FL
• Providers in Miramar Beach, FL by specialty
• General Practice Physician in Florida

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