# NORTH FLORIDA MEDICAL GROUP

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

## Provider details

- **NPI number:** 1942516935
- **Authorized official:** MRS. KIM D SHINSKY (ADMINISTRATOR)
- **Authorized official phone:** (850) 867-2006

## Contact information

- **Practice address:** 1702 OHIO AVE, LYNN HAVEN, FL 32444-4290
- **Practice address phone:** (850) 747-2010
- **Practice address fax:** (850) 747-2016
- **Mailing address:** 1702 OHIO AVE, LYNN HAVEN, FL 32444-4290
- **Mailing address phone:** (850) 747-2010
- **Mailing address fax:** (850) 747-2016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208200000X | Plastic Surgery Physician | ME97726 | FL | — |
| 208600000X | Surgery Physician | ME95473 | FL | — |
| 208D00000X | General Practice Physician | ME103213 | FL | Yes |
| 363L00000X | Nurse Practitioner | ARNP2800032 | FL | — |

## Other

- **Enumeration date:** 08/27/2010
- **Last updated:** 08/27/2010