Organization
BEACHSIDE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN H. HAVINGA MD (PRESIDENT)
(850) 473-0100
Entity
Organization
Contact information
Practice address
123 BAPTIST WAY, PENSACOLA, FL 32503-2254
(850) 473-0100
(850) 473-0500
Mailing address
4951 GRANDE DR, PENSACOLA, FL 32504-8965
(850) 473-0100
(850) 473-0500
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Enumeration date
03/27/2025
Last updated
08/15/2025
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