MEDICARE: DR. LAURA JUNE SOLON BAKER M.D.

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	207L00000X	Anesthesiology Physician	026136	CT
2	207L00000X	Anesthesiology Physician	152815	NY
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME79370	FL
4	207Q00000X	Family Medicine Physician	ME79370	FL
5	261QP2300X	Primary Care Clinic/Center	ME79370	FL
6	207L00000X	Anesthesiology Physician	ME79370	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194892869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA JUNE SOLON BAKER M.D.

Provider Business Mailing Address
First Line	:	5105 BOWDEN RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5907
Country	:	US
Telephone Number	:	813-362-1171
Fax Number	:	813-221-4039

Provider Business Practice Location Address
First Line	:	5105 BOWDEN RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5907
Country	:	US
Telephone Number	:	904-374-0260
Fax Number	:	904-619-5463

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	02/27/2024

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