MEDICARE: BAPTIST CARDIOLOGY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	363A00000X	Physician Assistant
3	207RC0000X	Cardiovascular Disease Physician
4	207UN0901X	Nuclear Cardiology Physician
5	207RC0001X	Clinical Cardiac Electrophysiology Physician

General Provider Information

NPI Number	:	1659163400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST CARDIOLOGY INC

Provider Business Mailing Address
First Line	:	PO BOX 746652
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6652
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-376-4075

Provider Business Practice Location Address
First Line	:	14540 OLD SAINT AUGUSTINE RD STE 2317
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-7418
Country	:	US
Telephone Number	:	904-202-2342
Fax Number	:	904-376-3328

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TYRONE STEWART
Credential	:
Telephone Number	:	904-493-8400

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	03/03/2026

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Directions to “BAPTIST CARDIOLOGY INC ” Practice Location

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