MEDICARE: SACRED HEART MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1437825262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED HEART MEDICAL GROUP

Provider Business Mailing Address
First Line	:	4205 BELFORT RD STE 4015
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-3623
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 N RICHARD JACKSON BLVD STE 130
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-2514
Country	:	US
Telephone Number	:	850-278-3280
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JEAN VALLIER
Credential	:
Telephone Number	:	850-278-3280

Provider Enumeration Date	:	08/20/2021
Last Update Date	:	08/20/2021

Similar Medicare Providers

1851325484 — DR. RAND CECIL RITCHIE MD
Practice Location Address:

354 MAIN ST , SUITE C
PISMO BEACH, CA
93449-2514

Practice Phone: 805-773-3343
Practice Fax: 805-773-3342

1598821902 — RANDY M MARTINELLI L.D.O.
Practice Location Address:

2514 PGA BLVD
PALM BEACH GARDENS, FL
33410-2902

Practice Phone: 561-500-8884
Practice Fax: 561-500-8885

1952435885 — KIDS DENTAL KARE
Practice Location Address:

10900 LONG BEACH BLVD
LYNWOOD, CA
90262-2514

Practice Phone: 310-632-0202
Practice Fax:

1225261944 — MRS. BEATRIZ ADRIANA ESPINOZA RDA
Practice Location Address:

920 S BONNIE BEACH PL
LOS ANGELES, CA
90023-2514

Practice Phone: 310-820-9933
Practice Fax:

1144565565 — PINNACLE CONTRACTING, INC
Practice Location Address:

4108 EDINBURGH DR
VIRGINIA BEACH, VA
23452-2514

Practice Phone: 757-587-9471
Practice Fax:

1245575661 — AMANDA LOGAN BEHRENS
Practice Location Address:

4108 EDINBURGH DR
VIRGINIA BEACH, VA
23452-2514

Practice Phone: 757-685-2680
Practice Fax:

Directions to “SACRED HEART MEDICAL GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.