Provider Demographics
NPI:1174297626
Name:SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Entity Type:Organization
Organization Name:SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Other - Org Name:BAPTIST CLAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF REVENUE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-376-3760
Mailing Address - Street 1:PO BOX 45094
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32232-5094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1771 BAPTIST CLAY DR
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-8501
Practice Address - Country:US
Practice Address - Phone:904-516-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-06
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital