MEDICARE: BAPTIST SPECIALTY PHYSICIANS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician
2	2080P0202X	Pediatric Cardiology Physician	FL
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407226228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST SPECIALTY PHYSICIANS INC

Provider Business Mailing Address
First Line	:	PO BOX 746645
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6645
Country	:	US
Telephone Number	:	904-376-4083
Fax Number	:	904-391-5075

Provider Business Practice Location Address
First Line	:	1660 PRUDENTIAL DR STE 320
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8197
Country	:	US
Telephone Number	:	904-376-3707
Fax Number	:	904-391-5001

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. THABATA BATCHELOR
Credential	:
Telephone Number	:	904-202-5048

Provider Enumeration Date	:	10/06/2015
Last Update Date	:	01/29/2026

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Directions to “BAPTIST SPECIALTY PHYSICIANS INC ” Practice Location

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