Provider Demographics
NPI:1033597034
Name:ACCESS CARE MEDICAL GROUP
Entity Type:Organization
Organization Name:ACCESS CARE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:850-377-0210
Mailing Address - Street 1:6705 PINE FOREST RD
Mailing Address - Street 2:SUITE 505
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-6911
Mailing Address - Country:US
Mailing Address - Phone:850-912-6588
Mailing Address - Fax:850-912-6598
Practice Address - Street 1:6705 PINE FOREST RD
Practice Address - Street 2:SUITE 505
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-6911
Practice Address - Country:US
Practice Address - Phone:850-912-6588
Practice Address - Fax:850-912-6598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP579162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty