Provider Demographics
NPI:1912307315
Name:BAYMEADOWS PEDIATRIC CARE INC
Entity Type:Organization
Organization Name:BAYMEADOWS PEDIATRIC CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABA
Authorized Official - Middle Name:H
Authorized Official - Last Name:JAFRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-518-5586
Mailing Address - Street 1:9770 OLD BAYMEADOWS RD
Mailing Address - Street 2:SUITE 127
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9770 OLD BAYMEADOWS RD
Practice Address - Street 2:SUITE 127
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7909
Practice Address - Country:US
Practice Address - Phone:904-518-5586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty