NPI Code Details Logo

NPI 1821155912

NPI 1821155912 : BAPTIST MEDICAL CENTER OF THE BEACHES, INC : JACKSONVILLE BEACH, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1821155912
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    BAPTIST MEDICAL CENTER OF THE BEACHES, INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/02/2007
-----------------------------------------------------
    Last Update Date     |    06/02/2022
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1350 13TH AVE S 
-----------------------------------------------------
    City                 |    JACKSONVILLE BEACH
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    32250-3203
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    904-376-4182
-----------------------------------------------------
    Fax                  |    904-376-4280
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    P O BOX 45058 
-----------------------------------------------------
    City                 |    JACKSONVILLE
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    32232-5058
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    904-376-4182
-----------------------------------------------------
    Fax                  |    904-376-4280
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CHIEF REVENUE OFFICER
-----------------------------------------------------
    Name                 |     PHILIP  BOYCE 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    904-376-3760
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    282N00000X
-----------------------------------------------------
    Taxonomy Name        |    General Acute Care Hospital
-----------------------------------------------------
    License Number       |    4304
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.