Organization
BAPTIST PRIMARY CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BETH (VICE PRESIDENT)
(904) 202-3283
Entity
Organization
Contact information
Practice address
1210 VINTAGE WAY, FERNANDINA BEACH, FL 32034-0299
(904) 261-0922
(904) 390-7477
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2654954-00
—
FL
01
—
45274
BCBS GROUP
FL
Enumeration date
09/14/2010
Last updated
03/03/2026
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