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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 Specialty Code Provider Type

Nephrology

207RN0300X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

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

NPI Number 1427160571
LBN Legal business name SHORELINE MEDICAL GROUP, P.A.
Authorized official THOMAS CURRY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/31/2006
Last updated 12/19/2018 - About 7 years ago
Identifiers
FL Medicaid 377827400
Other 10-3887 MEDICARE RHC
FL Other 377827401 MEDICAID RHC
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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