SOUTH WALTON MEDICAL
NPI 1871734541
Clinic/Center in Miramar Beach, FL
- Organization
- Clinic/Center
- CLIA Number: 10D1102027
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-08-2027
About SOUTH WALTON MEDICAL
This page provides the complete NPI Profile along with additional information for South Walton Medical, a provider established in Miramar Beach, Florida operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1871734541 assigned on March 2009. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as South Walton Medical. The authorized official of this NPI record is Perry Monty Reeves (Ceo)
- NPI
- 1871734541 Verify this NPI
- Provider Legal Name
- ROCK STAR REP INC
- Other Organization Name
- SOUTH WALTON MEDICAL
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 10065 US HIGHWAY 98 W STE B 101 MIRAMAR BEACH, FL 32550
- Location Phone
- (850) 837-8005
- Location Fax
- (850) 837-4352
- Mailing Address
- 5305 OAKWAY DR LAKELAND, FL 33805
- Mailing Phone
- (863) 513-0349
- Mailing Fax
- (863) 248-0453
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-10-2009
- Last Update Date
- 04-09-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D1102027
- Facility Type
- Physician Office
- Certificate Effective Date
- July 09, 2025
- Certificate Expiration Date
- July 08, 2027
- Laboratory Director
- TERRANCE R. REEVES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to South Walton Medical to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1871734541, enumerated as an "organization" on March 10, 2009.
The provider is located at 10065 US HIGHWAY 98 W STE B 101 MIRAMAR BEACH, FL 32550 and the phone number is (850) 837-8005.
Clinic/Center with taxonomy code 261Q00000X.
