Healthcare Provider Details

I. General information

NPI: 1487971842
Provider Name (Legal Business Name): BALDWIN PEDIATRIX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6789 SOUTHPOINT PKWY STE 202
JACKSONVILLE FL
32216-8206
US

IV. Provider business mailing address

PO BOX 551269
JACKSONVILLE FL
32255-1269
US

V. Phone/Fax

Practice location:
  • Phone: 904-853-1763
  • Fax: 850-248-2469
Mailing address:
  • Phone: 904-853-1763
  • Fax: 850-248-2469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: RUBINA AZAM
Title or Position: OWNER
Credential: MD
Phone: 904-853-1763