Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME0070987 | FL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME070987 | FL |
N | 207YP0228X | Pediatric Otolaryngology | ME070987 | FL |
NPI | 1750378170 |
---|---|
Provider Name | Dr. Pamela B Baines |
First Address | Tampa, FL 33619-8327 |
Second Address | Tampa, FL 33603-1405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 03/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250293300 | (05) | FL |
31681 | BLUE CROSS BLUE SHIELD (01) | FL |
F39465 | (02) | FL |