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

Life Management of NW Fl, Inc

Organization Psychiatry Physician · NPI 1316977515

Life Management of NW Fl, Inc provides Psychiatry Physician services 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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