Basic Information
| Provider Information | |||||||||
| NPI: | 1790926814 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COMPTON | ||||||||
| FirstName: | CENA | ||||||||
| MiddleName: | DARLENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KRAFT | ||||||||
| OtherFirstName: | CENA | ||||||||
| OtherMiddleName: | DARLENE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1005 MAR WALT DRIVE | ||||||||
| Address2: | |||||||||
| City: | FORT WALTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325476796 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8508638100 | ||||||||
| FaxNumber: | 8508634152 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 E HIGHWAY 20 | ||||||||
| Address2: | FAMILY MEDICINE DEPARTMENT | ||||||||
| City: | NICEVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325788826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8508974400 | ||||||||
| FaxNumber: | 8508970623 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2009 | ||||||||
| LastUpdateDate: | 08/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A-1584-10 | NM | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS13522 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.