MEDICARE: MRS. KRISTINA MADDEN BAUM M.S.

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	235Z00000X	Speech-Language Pathologist	SA9459	FL

General Provider Information

NPI Number	:	1457541815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTINA MADDEN BAUM M.S.

Provider Business Mailing Address
First Line	:	5919 BAYOU GRANDE BLVD NE
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33703-1821
Country	:	US
Telephone Number	:	727-240-6209
Fax Number	:

Provider Business Practice Location Address
First Line	:	10901 ROOSEVELT BLVD N STE 800
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33716-2305
Country	:	US
Telephone Number	:	727-240-6209
Fax Number	:

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	04/22/2024

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Directions to “ MRS. KRISTINA MADDEN BAUM M.S.” Practice Location

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