Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME149019 | FL |
NPI | 1346603321 |
---|---|
Provider Name | James Baker |
First Address | Weston, FL 33331-3609 |
Second Address | Weston, FL 33331-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2016 |
Last Update Date | 28/06/2021 |