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

Emerald Coast Neck & Back Clinic, PA

Organization Orthopaedic Surgery Physician · NPI 1386916237

Emerald Coast Neck & Back Clinic, PA is an Orthopaedic Surgery Physician in Niceville, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1003 College Blvd W Ste 4
Niceville, FL 32578-1068
Phone: (850) 279-6485
Fax: (850) 279-6546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery of the Spine Physician (primary) Taxonomy 207XS0117X · Licence ME0053933 (FL)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence ME0053933 (FL)

Record details

NPI number1386916237
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christo Koulisis — President · (850) 279-6485
NPI enumeratedFebruary 7, 2012
Last updated in NPPESDecember 29, 2022
Certification dateDecember 29, 2022
Mailing address1003 College Blvd W, Suite 4, Niceville, FL 32578-1068

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