Provider Demographics
NPI:1063680528
Name:OKALOOSA PULMONARY & SLEEP MEDICINE CLINIC
Entity Type:Organization
Organization Name:OKALOOSA PULMONARY & SLEEP MEDICINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP
Authorized Official - Phone:850-423-0561
Mailing Address - Street 1:131 E REDSTONE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-5326
Mailing Address - Country:US
Mailing Address - Phone:850-423-0561
Mailing Address - Fax:850-682-0141
Practice Address - Street 1:131 E REDSTONE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5326
Practice Address - Country:US
Practice Address - Phone:850-423-0561
Practice Address - Fax:850-682-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93191174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8225Medicare UPIN