Provider Demographics
NPI:1750159604
Name:SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Entity type:Organization
Organization Name:SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF REVENUE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-376-3760
Mailing Address - Street 1:PO BOX 746630
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6630
Mailing Address - Country:US
Mailing Address - Phone:904-376-4149
Mailing Address - Fax:904-618-2159
Practice Address - Street 1:461 OUTLET MALL BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-2493
Practice Address - Country:US
Practice Address - Phone:904-376-4149
Practice Address - Fax:904-618-2159
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-19
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital