Provider Demographics
NPI:1710375670
Name:EMERALD SHORES RHEUMATOLOGY INC
Entity Type:Organization
Organization Name:EMERALD SHORES RHEUMATOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-684-3445
Mailing Address - Street 1:1290 WHISPER BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2677
Mailing Address - Country:US
Mailing Address - Phone:850-684-3445
Mailing Address - Fax:850-684-3446
Practice Address - Street 1:1290 WHISPER BAY BLVD
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-2677
Practice Address - Country:US
Practice Address - Phone:850-684-3445
Practice Address - Fax:850-684-3446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107420207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty