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General NPI Number Information
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NPI Number | 1659163400
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Entity Type | Organization
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Legal Business Name | BAPTIST CARDIOLOGY INC
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 14540 OLD SAINT AUGUSTINE RD STE 2317
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7418
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Country | US
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Telephone | 904-202-2342
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Fax | 904-376-3328
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Provider Business Mailing Address
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Address Line | PO BOX 746652
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City | ATLANTA
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State | GA
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Zip | 30374-6652
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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 | TYRONE STEWART
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Credential |
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Telephone | 904-425-4625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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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 | 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 #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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