Healthcare Provider Details

I. General information

NPI: 1245884535
Provider Name (Legal Business Name): BAKER MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 WEST AVE STE 17
MIAMI BEACH FL
33139-5214
US

IV. Provider business mailing address

18473 SW 89TH PL
MIAMI FL
33157-7162
US

V. Phone/Fax

Practice location:
  • Phone: 786-490-6200
  • Fax: 954-634-4293
Mailing address:
  • Phone: 786-490-6200
  • Fax: 954-634-4293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY T BAKER
Title or Position: OWNER
Credential: DO
Phone: 786-490-6200