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

Life Management of NW Fl, Inc

Organization Psychiatry Physician · NPI 1316977515

Life Management of NW Fl, Inc is a Psychiatry Physician in Port St Joe, Florida. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

311 Williams Ave
Port St Joe, FL 32456-1845
Phone: (850) 522-4480
Fax: (850) 914-6281
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X
Community/Behavioral Health Agency Taxonomy 251S00000X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1316977515
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLife Management Center of Northwest Florida, Inc
Authorized official Edwin Ailes — Ceo/President · (850) 522-4485
Other names Life Management Center Of Northwest Florida Inc
NPI enumeratedJuly 4, 2006
Last updated in NPPESApril 24, 2025
Certification dateApril 24, 2025
Mailing address525 E 15th St, Panama City, FL 32405-5412

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