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General NPI Number Information
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NPI Number | 1124956958
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Entity Type | Organization
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Legal Business Name | BAPTIST NEUROLOGY INC
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 1370 13TH AVE S STE 118
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-3206
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Country | US
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Telephone | 904-398-5407
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Fax | 904-391-5779
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Provider Business Mailing Address
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Address Line | PO BOX 746649
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City | ATLANTA
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State | GA
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Zip | 30374-6649
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Country | US
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Telephone | 904-202-2092
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Fax | 904-376-4075
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Authorized Official
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Title or Position | MANAGER, CREDENTIALS
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Name | TYRONE MCCLOUD
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Credential |
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Telephone | 904-202-5367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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