MEDICARE: DR. DEBORAH R BAUM MD

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	207RP1001X	Pulmonary Disease Physician	ME0070654	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4101242	OTHER		ECFMG

General Provider Information

NPI Number	:	1215919733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH R BAUM MD

Provider Business Mailing Address
First Line	:	1601 CLINT MOORE RD
Second Line	:	100
City	:	BOCA RATON
State	:	FL
Zip	:	33487-2768
Country	:	US
Telephone Number	:	561-939-0200
Fax Number	:	561-939-0274

Provider Business Practice Location Address
First Line	:	1601 CLINT MOORE RD
Second Line	:	100
City	:	BOCA RATON
State	:	FL
Zip	:	33487-2768
Country	:	US
Telephone Number	:	561-939-0200
Fax Number	:	561-939-0274

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	07/11/2007

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