MEDICARE: DR. VICTORIA BASKIN 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	2084P0804X	Child & Adolescent Psychiatry Physician	124909	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

General Provider Information

NPI Number	:	1801831409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA BASKIN M.D.

Provider Business Mailing Address
First Line	:	919 NE 13TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-2009
Country	:	US
Telephone Number	:	954-763-2030
Fax Number	:	954-763-9847

Provider Business Practice Location Address
First Line	:	871 W OAKLAND PARK BLVD
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33311-1731
Country	:	US
Telephone Number	:	954-567-7141
Fax Number	:	954-565-5624

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	01/26/2017

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