Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME71406 | FL |
NPI | 1083677116 |
---|---|
Provider Name | Dr. Robert Wells Baylis |
First Address | Plantation, FL 33324-1849 |
Second Address | Plantation, FL 33324-1849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 22/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G36070 | (02) | FL |