| Baymeadows Healthcare | |
|
10058 Baymeadows Rd Jacksonville FL 32256-7177 | |
| (904) 636-5400 | |
| (904) 928-0654 |
| Full Name | Baymeadows Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 10058 Baymeadows Rd, Jacksonville, Florida |
| Authorized Official Name and Position | S. Awais Imam (PRACTICE ADMINISTRATOR/ CFO) |
| Authorized Official Contact | 9046365400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baymeadows Healthcare 10058 Baymeadows Rd Jacksonville FL 32256-7177 Ph: (904) 636-5400 | Baymeadows Healthcare 10058 Baymeadows Rd Jacksonville FL 32256-7177 Ph: (904) 636-5400 |
| NPI Number | 1174512701 |
|---|---|
| Provider Enumeration Date | 10/17/2005 |
| Last Update Date | 03/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174512701 | NPI | - | NPPES |
| 273849000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME71382 (Florida) | Primary |
| 207R00000X | Internal Medicine | ME81517 (Florida) | Secondary |
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