MEDICARE: BAPTIST CARDIOLOGY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RC0001X	Clinical Cardiac Electrophysiology Physician
2	207RI0011X	Interventional Cardiology Physician
3	363A00000X	Physician Assistant
4	363L00000X	Nurse Practitioner
5	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1649100876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST CARDIOLOGY INC

Provider Business Mailing Address
First Line	:	PO BOX 746652
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6652
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-376-4075

Provider Business Practice Location Address
First Line	:	8595 SAINT JOHNS PKWY STE B207
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32092-2064
Country	:	US
Telephone Number	:	904-376-3630
Fax Number	:	904-618-2143

Authorized Official
Title or Position	:	EXECUTIVE ADMINISTRATOR
Name	:	TYRONE STEWART
Credential	:
Telephone Number	:	904-425-4625

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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