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NPI Code Detail

MEDICARE: BAPTIST CARDIOLOGY, INC.

MEDICARE: BAPTIST CARDIOLOGY, INC.
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
1173F00000XSleep Specialist (PhD)

General Provider Information

NPI Number : 1376803155
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAPTIST CARDIOLOGY, INC.
Provider Business Mailing Address
First Line : 1905 CORPORATE SQUARE BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-1940
Country : US
Telephone Number : 904-720-0799
Fax Number : 904-720-5225
Provider Business Practice Location Address
First Line : 6930 BONNEVAL RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-6084
Country : US
Telephone Number : 904-854-6899
Fax Number : 904-338-0533
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MARK A MASTERS
Credential :
Telephone Number : 904-720-0799
Provider Enumeration Date : 05/25/2012
Last Update Date : 05/25/2012

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Directions to “BAPTIST CARDIOLOGY, INC. ” Practice Location

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