Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME0053603 | FL |
NPI | 1699797928 |
---|---|
Provider Name | Dr. Bret O Baynham |
First Address | Palm Beach Gardens, FL 33410-2823 |
Second Address | Palm Beach Gardens, FL 33410-4627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 16/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063087000 | (05) | FL |