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Organization
SHORELINE MEDICAL GROUP, P.A.
Active
Organization
SHORELINE MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS L CURRY M.D. (PRESIDENT)
(850) 229-8010
Entity
Organization
Contact information
Practice address
419 BALTZELL AVE, PORT ST JOE, FL 32456
(850) 229-8010
(850) 227-3177
Mailing address
419 BALTZELL AVE, PORT ST JOE, FL 32456-1864
(850) 229-8010
(850) 227-3177
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-3887
MEDICARE RHC
—
05
—
377827400
—
FL
01
—
377827401
MEDICAID RHC
FL
Enumeration date
08/31/2006
Last updated
12/19/2018
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