Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 2019006016 | MO |
Y | 2084N0400X | Neurologist | ME144949 | FL |
NPI | 1003298852 |
---|---|
Provider Name | Dr. Brandi Janece Baker |
First Address | Miramar, FL 33025-3925 |
Second Address | Weston, FL 33326-2394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2015 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107413300 | (05) | FL |