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

Life Management Center of Northwest Florida Inc

Organization Psychiatry Physician · NPI 1710912886

Life Management Center of Northwest Florida Inc provides Psychiatry Physician services in Bonifay, Florida. Registered with an NPI since 2006.

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

See every abbreviation used in this directory →

Practice location Address checks out

310 E Byrd Ave
Bonifay, FL 32425-3006
Phone: (850) 522-4480
Fax: (850) 914-6281
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1710912886
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLife Management Center of Northwest Florida, Inc
Authorized official Edwin Ailes — Executive Director · (850) 522-4480
Other names Life Management Center Of Northwest Florida Inc
NPI enumeratedJuly 11, 2006
Last updated in NPPESApril 24, 2025
Certification dateApril 24, 2025
Mailing address525 E 15th St, Panama City, FL 32405-5412