Organization
LYERLY BAPTIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J. GORAK MD (VP, MEDICAL DIRECTOR OF OPERATIONS)
(904) 202-7300
Entity
Organization
Contact information
Practice address
14540 OLD SAINT AUGUSTINE RD STE 2207, JACKSONVILLE, FL 32258-7419
(904) 388-6518
(904) 384-1005
Mailing address
PO BOX 746647, ATLANTA, GA 30374-6647
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/12/2023
Last updated
03/03/2026
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