MEDICARE: ANDREW ZEE BAKER LMHC

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	101YM0800X	Mental Health Counselor	MH14713	FL

General Provider Information

NPI Number	:	1558806661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ZEE BAKER LMHC

Provider Business Mailing Address
First Line	:	9180 SW 5TH ST APT B
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-6329
Country	:	US
Telephone Number	:	772-332-4622
Fax Number	:	561-272-7250

Provider Business Practice Location Address
First Line	:	430 NE 5TH AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5664
Country	:	US
Telephone Number	:	772-332-4622
Fax Number	:	561-272-7250

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

Provider Enumeration Date	:	12/28/2016
Last Update Date	:	12/28/2016

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