SAINT GEORGE MEDICAL CENTER INC NPI 1184137929

NPI Information

NPI: 1184137929
Provider Name: SAINT GEORGE MEDICAL CENTER INC
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 10D2149683

Address:
1118 HOSPITAL RD
FORT WALTON BEACH, FL
ZIP 32547
Phone: (850) 862-3415
Get Directions

SAINT GEORGE MEDICAL CENTER INC is a geriatric medicine family medicine in Fort Walton Beach, FL. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. SAINT GEORGE MEDICAL CENTER INC NPI is 1184137929. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1118 HOSPITAL RD
FORT WALTON BEACH, FL
ZIP 32547-742
Phone: (850) 862-3415

The provider's authorized official is Erica George-saintilus .
The authorized official title is Owner and has the following contact phone number (850) 862-3415.

The CLIA number assigned to this NPI record is 10D2149683 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2017 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QG0300X	Family Medicine	Geriatric Medicine	ME100869	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	190605	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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