BEACHSIDE MEDICAL GROUP LLC
NPI 1144022146
Pediatrics - Neonatal-Perinatal Medicine in Pensacola, FL

Q: What is Beachside Medical Group LLC's NPI number?

The NPI number for Beachside Medical Group LLC is 1144022146. It was assigned to this organization in the NPPES registry on March 27, 2025.

Q: What is Beachside Medical Group LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Active since March 27, 2025

123 BAPTIST WAY, PENSACOLA, FL 32503(850) 473-0100(850) 473-0500 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 15, 2025, Apr 4, 2025, Mar 27, 2025 (3 updates tracked since 2025).

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About Beachside Medical Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACHSIDE MEDICAL GROUP LLC (NPI 1144022146) is a healthcare organization registered as a neonatal-perinatal medicine in Pensacola, Florida and active in the NPI registry since March 2025. The organization maintains 2 additional practice locations and lists Jaclyn H. Havinga, President, as its authorized official.

NPPES Registry Identity

NPI1144022146

Entity TypeOrganization

Primary Taxonomy2080N0001X

Legal Business NameBEACHSIDE MEDICAL GROUP LLC

Location Address123 BAPTIST WAYPensacola, FL 32503-2254

Mailing Address4951 Grande DrPensacola, FL 32504-8965 · (850) 473-0100 · Fax (850) 473-0500

Phone(850) 473-0100

Fax(850) 473-0500

Organization SubpartNo

Authorized OfficialJaclyn H. HavingaPresident · (850) 473-0100

Enumeration DateMarch 27, 2025

Last NPPES UpdateAugust 15, 20253 updates tracked since enumeration

NPPES CertifiedAugust 15, 2025

✔ NPI 1144022146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

Definition

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.

123 BAPTIST WAY, Pensacola, FL 32503

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Secondary Practice Locations 2

Location 18383 N Davis HwyPensacola, FL 32514-6039 · Phone (850) 473-0100 · Fax (850) 473-0500

Location 25151 N 9th AvePensacola, FL 32504-8721 · Phone (850) 473-0100 · Fax (850) 473-0500

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. EDWIN BLADIMIR GAVARRETE CRNA

Nurse Anesthetist, Certified Registered