# SACRED HEART MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SHMG Watersound OBGYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184396582
- **Authorized official:** JEAN VALLIER (DIRECTOR)
- **Authorized official phone:** (850) 608-6405

## Contact information

- **Practice address:** 180 N WATERSOUND PKWY, INLET BEACH, FL 32461-7274
- **Practice address phone:** (850) 608-6405
- **Mailing address:** 4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/04/2021
- **Last updated:** 10/04/2021