Healthcare Provider Details

I. General information

NPI: 1780217174
Provider Name (Legal Business Name): AMBER BAKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2020
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 N COURTENAY PKWY UNIT 6
MERRITT ISLAND FL
32953-5213
US

IV. Provider business mailing address

3000 MURRELL RD # 561272
ROCKLEDGE FL
32955-4431
US

V. Phone/Fax

Practice location:
  • Phone: 321-914-9980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9622867
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: