Provider profile · NPI 1003528258

12th Avenue Healthcare, Inc

Nurse Practitioner, Family · Pensacola, FL · NPI 1003528258 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Nurse Practitioner, Family

Enumerated

Dec 20, 2022

License(s)

Addresses on file

PurposeAddressCity/StatePhone
MAILING9735 N PALAFOX ST Pensacola, FL 32534-1224850-776-7872
LOCATION1101 OFFICE WOODS DR Pensacola, FL 32504-5937850-776-7872

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