| Organization Name: | FORT WALTON BEACH MEDICAL CENTER, INC. |
| NPI Number: | 1326093246 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VINCE WYATT (CFO) |
| Mailing Address: | 1000 Mar Walt Dr Ft Walton Beach |
| State: | FL US |
| Postal Code: | 325476708 |
| Phone Number: | 8508621111 |
| Fax Number: | 8508629149 |
| NPI Enumeration Date: | 05/23/2006 |
| NPI Last Update Date: | 10/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 273R00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospital Units |
| Taxonomy Classification: | Psychiatric Unit |
| Taxonomy Specialization: | |
| Taxonomy Definition: | In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians |