MEDICARE: CHASE BARUCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		FL

General Provider Information

NPI Number	:	1073462040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHASE BARUCH

Provider Business Mailing Address
First Line	:	15169 78TH DR N
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-7320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 SHIRCLIFF WAY STE 200
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4766
Country	:	US
Telephone Number	:	904-308-2006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “ CHASE BARUCH ” Practice Location

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