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General NPI Number Information
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NPI Number | 1609286897
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Entity Type | Organization
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Legal Business Name | BAPTIST MD ANDERSON CANCER PHYSICIANS INC
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1235 SAN MARCO BLVD STE 200A
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8557
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Country | US
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Telephone | 904-202-7300
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Fax | 904-202-2754
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Provider Business Mailing Address
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Address Line | PO BOX 746654
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City | ATLANTA
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State | GA
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Zip | 30374-6654
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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 | ADMINISTRATOR
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Name | LEEANN MENGEL
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Credential |
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Telephone | 904-376-4275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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