Organization
SAINT GEORGE MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA GEORGE-SAINTILUS MD (OWNER)
(850) 862-3415
Entity
Organization
Contact information
Practice address
1118 HOSPITAL RD, FORT WALTON BEACH, FL 32547-6742
(850) 862-3415
Mailing address
790 BARLEY PORT LN, FORT WALTON BEACH, FL 32547-5722
(850) 862-3415
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
ME100869
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190605
—
FL
Enumeration date
11/15/2017
Last updated
06/16/2018
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