Provider Demographics
NPI:1609431493
Name:CHILDREN'S ORTHOPAEDIC INSTITUTE OF NORTHWEST FLORIDA, LLC
Entity Type:Organization
Organization Name:CHILDREN'S ORTHOPAEDIC INSTITUTE OF NORTHWEST FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PO-CHEN
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-356-2467
Mailing Address - Street 1:1910 E BLOUNT ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6126
Mailing Address - Country:US
Mailing Address - Phone:850-356-2467
Mailing Address - Fax:
Practice Address - Street 1:710 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-7380
Practice Address - Country:US
Practice Address - Phone:850-356-2467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty