Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH 3676 | FL |
N | 111NI0013X | Independent Medical Examiner | CH 3676 | FL |
N | 111NR0400X | Rehabilitation Chiropractor | CH 3676 | FL |
NPI | 1073514436 |
---|---|
Provider Name | Dr. Michael Norman Baum |
First Address | Miami Beach, FL 33141-3645 |
Second Address | Miami Beach, FL 33141-3645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 09/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050317700 | (05) | FL |
T55944 | (02) | FL |