National Provider Identifier Database

SHORELINE MEDICAL GROUP PA
Nephrology

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.


Contact Information

SHORELINE MEDICAL GROUP, P.A.
419 BALTZELL AVE
PORT SAINT JOE, FL32456
Phone: 850-229-8010
Fax: 850-227-3177
Website:
Specialty Taxonomy Code
* Nephrology 207RN0300X
Internal Medicine 207R00000X
Pediatrics 208000000X
Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for SHORELINE MEDICAL GROUP, P.A.

NPI Number 1427160571
Legal business name
LBN
SHORELINE MEDICAL GROUP, P.A.
Authorized official THOMAS CURRY - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 08/31/2006
Last updated 12/19/2018 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • FL Medicaid: 377827400
  • Other: 10-3887 MEDICARE RHC
  • FL Other: 377827401 MEDICAID RHC

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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