Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | ME 127474 | FL |
N | 2084N0600X | Clinical Neurophysiologist | ME 127474 | FL |
NPI | 1427348978 |
---|---|
Provider Name | Dr. Omar Baez |
First Address | Doral, FL 33172-1603 |
Second Address | Doral, FL 33172-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 02/07/2016 |