Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME58037 | FL |
N | 2080P0204X | Pediatric Emergency Doctor | ME58037 | FL |
NPI | 1770697054 |
---|---|
Provider Name | Rodney Baker |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 21/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
053304100 | (05) | FL |