# SEAGROVE BEACH MEDICAL CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710022827
- **Authorized official:** MR. GEORGE NORMAN ROLL PA-C,MS,BA,BS,MPA (OWNER)
- **Authorized official phone:** (850) 231-6200

## Contact information

- **Practice address:** 5399 E COUNTY HIGHWAY 30A, SUITE 5, SANTA ROSA BEACH, FL 32459-6717
- **Practice address phone:** (850) 231-6200
- **Practice address fax:** (850) 231-3500
- **Mailing address:** 5399 E COUNTY HIGHWAY 30A, SUITE 5, SANTA ROSA BEACH, FL 32459-6717
- **Mailing address phone:** (850) 231-6200
- **Mailing address fax:** (850) 231-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | PA3191 | FL | Yes |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 12/18/2013