BEACHSIDE PRIMARY CARE LLC
NPI 1386364032
Clinic/Center - Primary Care in Jacksonville Beach, FL

Q: What is Beachside Primary Care LLC's NPI number?

The NPI number for Beachside Primary Care LLC is 1386364032. It was assigned to this organization in the NPPES registry on September 1, 2022.

Q: What is Beachside Primary Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since September 01, 2022CLIA 10D2269580 · Waiver

1825 3RD ST N STE B, JACKSONVILLE BEACH, FL 32250(904) 595-5826(904) 595-5827 Get Directions Write a Review

NPPES record last updated: December 16, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 16, 2022, Sep 1, 2022 (2 updates tracked since 2022).

On this page

About Beachside Primary Care Llc NPPES

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

BEACHSIDE PRIMARY CARE LLC (NPI 1386364032) is a healthcare organization registered as a primary care in Jacksonville Beach, Florida and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through September 28, 2026 and lists Deborah Ghandour, President, as its authorized official.

NPPES Registry Identity

NPI1386364032

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameBEACHSIDE PRIMARY CARE LLC

Location Address1825 3RD ST N STE BJacksonville Beach, FL 32250-4840

Mailing Address1825 3rd St N Ste BJacksonville Beach, FL 32250-4840

Phone(904) 595-5826

Fax(904) 595-5827

Organization SubpartNo

Authorized OfficialDeborah GhandourPresident · (904) 595-5826

Enumeration DateSeptember 1, 2022

Last NPPES UpdateDecember 16, 20222 updates tracked since enumeration

NPPES CertifiedDecember 16, 2022

✔ NPI 1386364032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

1825 3RD ST N STE B, Jacksonville Beach, FL 32250

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

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 10D2269580

Beachside Primary Care LLC · Jacksonville Beach, FL

Active · expires Sep 28, 2026

CLIA Number10D2269580

Laboratory TypePhysician Office

Certificate Effective DateSeptember 29, 2024

Certificate Expiration DateSeptember 28, 2026

Laboratory DirectorDeborah L. Ghandour

Laboratory Phone(904) 595-5826

Laboratory LocationBeachside Primary Care LLC1825B 3rd St N, Jacksonville Beach, FL 32250

CLIA data matches this NPI record on: 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.

DR. DEBORAH LANE GHANDOUR PA-C, DHSC

Physician Assistant (Medical)

1825 3RD ST N STE B
JACKSONVILLE BEACH, FL 32250

Duval County (904) 595-5826

MOORE BOUTIQUE, LLC

In Home Supportive Care

1825 3RD ST N STE B
JACKSONVILLE BEACH, FL 32250

Duval County (904) 372-4534

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 Beachside Primary Care LLC's NPI number?

The NPI number for Beachside Primary Care LLC is 1386364032. It was assigned to this organization in the NPPES registry on September 1, 2022.

Where is Beachside Primary Care LLC located?

Beachside Primary Care LLC is located at 1825 3rd St N Ste B, Jacksonville Beach, FL 32250. The listed phone number is (904) 595-5826.

What is Beachside Primary Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Beachside Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2269580) is associated with this NPI, valid through September 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beachside Primary Care LLC accept?

Health plans from Molina Healthcare list Beachside Primary Care LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Beachside Primary Care LLC was last updated on December 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.