Provider Demographics
NPI:1558553479
Name:BAPTIST HEALTH MEDICAL GROUP UPPER KEYS, LLC
Entity Type:Organization
Organization Name:BAPTIST HEALTH MEDICAL GROUP UPPER KEYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSENAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-662-7111
Mailing Address - Street 1:6855 S RED RD STE 540
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3647
Mailing Address - Country:US
Mailing Address - Phone:786-662-7980
Mailing Address - Fax:786-533-9403
Practice Address - Street 1:91550 OVERSEAS HIGHWAY
Practice Address - Street 2:SUITE 215
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070
Practice Address - Country:US
Practice Address - Phone:786-662-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00500OtherBLUE CROSS BLUE SHIELD
FL00500OtherBLUE CROSS BLUE SHIELD