Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Eglin Air Force Base Residency Program

Organization Family Medicine Physician · NPI 1538504063

Eglin Air Force Base Residency Program provides Family Medicine Physician services 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 Not confirmed with CMS for 13 years — call before visiting
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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