MEDICARE: BAPTIST HEALTH MEDICAL GROUP PHYSICIANS, LLC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1639832249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST HEALTH MEDICAL GROUP PHYSICIANS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 198054
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-8054
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 SW 72ND ST STE 601
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5004
Country	:	US
Telephone Number	:	786-595-8080
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MATTHEW ARSENAULT
Credential	:
Telephone Number	:	786-662-7111

Provider Enumeration Date	:	10/20/2021
Last Update Date	:	10/20/2021

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