SAINT GEORGE MEDICAL CENTER INC
NPI 1184137929
Family Medicine - Geriatric Medicine in Fort Walton Beach, FL

Active since November 15, 2017CLIA 10D2149683 · Waiver
1118 HOSPITAL RD, FORT WALTON BEACH, FL 32547(850) 862-3415 Get Directions Write a Review

NPPES record last updated: June 16, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2018, Nov 15, 2017 (2 updates tracked since 2017).

About Saint George Medical Center Inc NPPES

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

SAINT GEORGE MEDICAL CENTER INC (NPI 1184137929) is a healthcare organization registered as a geriatric medicine in Fort Walton Beach, Florida and active in the NPI registry since November 2017. The organization holds a CLIA Waiver certificate valid through June 7, 2028 and lists Erica George-saintilus, Owner, as its authorized official.

NPPES Registry Identity

NPI1184137929
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameSAINT GEORGE MEDICAL CENTER INC
Location Address1118 HOSPITAL RDFort Walton Beach, FL 32547-6742
Mailing Address790 Barley Port LnFort Walton Beach, FL 32547-5722 · (850) 862-3415
Organization SubpartNo
Authorized OfficialErica George-saintilusOwner · (850) 862-3415
Enumeration DateNovember 15, 2017
Last NPPES UpdateJune 16, 20182 updates tracked since enumeration
NPI 1184137929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
License Licensed in FL · ME100869
Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

1118 HOSPITAL RD, Fort Walton Beach, FL 32547

Other Identifiers 1

Medicaid190605FL

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2149683

Saint George Medical Center Inc · Fort Walton Beach, FL
Active · expires Jun 7, 2028
CLIA Number10D2149683
Laboratory TypePhysician Office
Certificate Effective DateJune 8, 2026
Certificate Expiration DateJune 7, 2028
Laboratory DirectorDubner Saintilus
Laboratory Phone(850) 862-3415
Laboratory LocationSaint George Medical Center Inc1118 Hospital Road, Fort Walton Beach, FL 32547
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner (Adult Health)
1118 HOSPITAL RD
FORT WALTON BEACH, FL 32547
Nurse Practitioner (Family)
1118 HOSPITAL RD
FORT WALTON BEACH, FL 32547

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Saint George Medical Center Inc's NPI number?

The NPI number for Saint George Medical Center Inc is 1184137929. It was assigned to this organization in the NPPES registry on November 15, 2017.

Where is Saint George Medical Center Inc located?

Saint George Medical Center Inc is located at 1118 Hospital Rd, Fort Walton Beach, FL 32547. The listed phone number is (850) 862-3415.

What is Saint George Medical Center Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Does Saint George Medical Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2149683) is associated with this NPI, valid through June 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Saint George Medical Center Inc was last updated on June 16, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.