Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730272410 Individual Practitioner Male Practitioner

Dr. Jose A Luis , MD

Pediatrics • Fort Walton Beach, FL

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Jose Luis, MD is a registered healthcare professional specializing in Pediatrics in Fort Walton Beach, FL. Official NPI practice address is registered at 1005 MAR WALT DR.

Practice Location & Contact Primary Location

Practice Address

1005 Mar Walt Dr

Fort Walton Beach, FL 325476707

Telephone 8508638203
Fax 8508638118
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Fort Walton Beach, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
10 Specialists

Practicing in Fort Walton Beach, FL (4160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-06-17
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL ME164204

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
131254300 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Heather Shelton , ARNP

Nurse Practitioner

NPI 1083162457

Advanced Registered Nurse Practitioner

NPI 1265417166

Doctor of Medicine (M.D.)

NPI 1275519886

Doctor of Medicine (M.D.)

Paul Tartarilla , APRN

Nurse Practitioner

NPI 1285610899

Advanced Practice Registered Nurse

NPI 1477034114

Advanced Registered Nurse Practitioner

NPI 1487620845

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 17, 2026

Registered at 1005 MAR WALT DR, FORT WALTON BEACH, FL 325476707 (Tel: 8508638203)

📍
Updated Business Mailing Address June 17, 2026

Registered at 1005 MAR WALT DR, FORT WALTON BEACH, FL 325476707 (Tel: 8508638100)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 17, 2026

Pediatrics (License #ME164204 in FL)

NPI Profile Active May 08, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location May 08, 2009

Registered at 74 PHYSICIAN DR., AIKEN PEDIATRICS, P.A., AIKEN, SC 298016388 (Tel: 8036490578)

📍
Updated Business Mailing Address May 08, 2009

Registered at PO BOX 557367, MIAMI, FL 33255 (Tel: 7866245845)

👤
Provider Name / Credentials Updated May 08, 2009

Recorded as JOSE LUIS, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 08, 2009

Pediatrics (License #ME34113 in FL)

🟢
Initial NPI Registration & Enumeration October 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730272410
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 02, 2006
Last Update: June 17, 2026
Sole Proprietor: Yes

Mailing Address

1005 Mar Walt Dr

Fort Walton Beach, FL 325476707

Phone: 8508638100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.