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NPI Code Detail

MEDICARE: LYERLY BAPTIST INC

MEDICARE: LYERLY BAPTIST INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician

General Provider Information

NPI Number : 1336476795
Entity Type Code : Organization
Provider Name (Legal Business Name) : LYERLY BAPTIST INC
Provider Business Mailing Address
First Line : 1370 13TH AVE S STE 118
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3206
Country : US
Telephone Number : 904-388-6518
Fax Number : 904-384-1005
Provider Business Practice Location Address
First Line : 1370 13TH AVE S
Second Line : SUITE 215
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3230
Country : US
Telephone Number : 904-249-1041
Fax Number : 904-249-9764
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : TYRONE MCCLOUD
Credential :
Telephone Number : 904-202-5367
Provider Enumeration Date : 11/05/2009
Last Update Date : 03/03/2026

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1285741348 — BARBARA O'REILLY M.D., P.A.
Practice Location Address:
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Practice Phone: 904-246-8480
Practice Fax: 904-246-8578

Directions to “LYERLY BAPTIST INC ” Practice Location

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