MEDICARE: DR. RUBINA Y BAKERYWALA 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	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	245248	NY
2	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	ME109578	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	:	1861682940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUBINA Y BAKERYWALA M.D.

Provider Business Mailing Address
First Line	:	2601 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2112
Country	:	US
Telephone Number	:	904-203-4282
Fax Number	:	564-464-3967

Provider Business Practice Location Address
First Line	:	2601 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2112
Country	:	US
Telephone Number	:	904-203-4282
Fax Number	:	564-464-3967

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

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	01/28/2025

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