BEACHSIDE MEDICAL GROUP LLC – NPI #1740078799
Pediatrics

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

BEACHSIDE MEDICAL GROUP LLC is a provider located in PENSACOLA, FL. NPPES has assigned the NPI number 1740078799 to BEACHSIDE MEDICAL GROUP LLC on April 29, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2080N0001X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Neonatal-Perinatal Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BEACHSIDE MEDICAL GROUP LLC below.

NPI Profile for
BEACHSIDE MEDICAL GROUP LLC

NPI Number
1740078799
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BEACHSIDE MEDICAL GROUP LLC
Primary location
8383 N DAVIS HWY
PENSACOLA, FL 32514-6039
Phone: (850) 473-0100 Fax: (850) 473-0500
Mailing address
4951 GRANDE DR
PENSACOLA, FL 32504-8965
Phone: (850) 473-0100 Fax: (850) 473-0500
Organization Subpart
Yes - BEACHSIDE MEDICAL GROUP LLC is subpart of another organization.
Authorized Official
EVIE DUCKWORTH
CREDENTIALING MANAGER
Phone: (850) 478-1312
Updated
Certification Date
Apr 29, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080N0001X
- Pediatrics / Neonatal-Perinatal Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.