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BAPTIST-SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES INC NPI 1083153365


NPI Information

NPI: 1083153365
Provider Name: BAPTIST-SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES INC

Doing Business As: BAPTIST MD ANDERSON CANCER PHYSICIANS

Classification: Obstetrics & Gynecology - 207VX0201X
Entity Type: Organization

Specialization: Gynecologic Oncology

CLIA Number: 10D1034368

Address:
14540 OLD SAINT AUGUSTINE RD
SUITE 2593
JACKSONVILLE, FL
ZIP 32258
Phone: (904) 389-3993
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BAPTIST-SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES INC is a gynecologic oncology obstetrics gynecology in Jacksonville, FL. The provider is an obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. BAPTIST-SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES INC NPI is 1083153365. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Baptist Md Anderson Cancer Physicians.

The provider's business location address is:

14540 OLD SAINT AUGUSTINE RD
SUITE 2593
JACKSONVILLE, FL
ZIP 32258-418
Phone: (904) 389-3993
Fax: (904) 389-3994

The provider's authorized official is Leeann Mengel .
The authorized official title is Administrator and has the following contact phone number (904) 202-7300.

The CLIA number assigned to this NPI record is 10D1034368 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/20/2017 and was last updated on 2/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VX0201XObstetrics & GynecologyGynecologic OncologyFLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DU3570OTHERFLORIDARR MEDICARE
2HQ530AMEDICARE UPINFLORIDA
3009942200MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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