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NPI Code Detail

MEDICARE: TIMOTHY BRIAN BAKER

MEDICARE: TIMOTHY BRIAN BAKER
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
1390200000XStudent in an Organized Health Care Education/Training ProgramFL

General Provider Information

NPI Number : 1568307478
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY BRIAN BAKER
Provider Business Mailing Address
First Line : 1335 SLIGH BLVD STE 400
Second Line :
City : ORLANDO
State : FL
Zip : 32806-3901
Country : US
Telephone Number : 321-841-5142
Fax Number :
Provider Business Practice Location Address
First Line : 1335 SLIGH BLVD STE 200
Second Line :
City : ORLANDO
State : FL
Zip : 32806-3901
Country : US
Telephone Number : 407-649-6884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2026
Last Update Date : 04/20/2026

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Directions to “ TIMOTHY BRIAN BAKER ” Practice Location

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