Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eglin Air Force Base Residency Program

Organization Family Medicine Physician · NPI 1538504063

Eglin Air Force Base Residency Program is a Family Medicine Physician in St Petersburg, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013
Specialties on file
2
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Practice location Address checks out

11850 Dr Martin Luther King Jr St N Apt 22-312
St Petersburg, FL 33716-1619
Phone: (206) 883-5357
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (FL)
Clinic/Center Taxonomy 261Q00000X (FL)

Record details

NPI number1538504063
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christopher Paulson — Program Director · (850) 883-8192
NPI enumeratedMay 10, 2013
Last updated in NPPESMay 10, 2013
Mailing address11850 Dr Martin Luther King Jr St N, Apt 22-312, St Petersburg, FL 33716-1619

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