Healthcare Provider Details

I. General information

NPI: 1447924154
Provider Name (Legal Business Name): SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14550 OLD SAINT AUGUSTINE RD
JACKSONVILLE FL
32258-2460
US

IV. Provider business mailing address

PO BOX 45094
JACKSONVILLE FL
32232-5094
US

V. Phone/Fax

Practice location:
  • Phone: 904-271-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: PHILIP BOYCE
Title or Position: CHIEF REVENUE OFFICER
Credential:
Phone: 904-376-3760