Healthcare Provider Details

I. General information

NPI: 1366650962
Provider Name (Legal Business Name): BAUM CHIROPRACTIC CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 71ST ST
MIAMI BEACH FL
33141-3645
US

IV. Provider business mailing address

1175 71ST ST
MIAMI BEACH FL
33141-3645
US

V. Phone/Fax

Practice location:
  • Phone: 305-864-1419
  • Fax: 305-861-7246
Mailing address:
  • Phone: 305-864-1419
  • Fax: 305-861-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCH 3676
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH 3676
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberCH 3676
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 3676
License Number StateFL

VIII. Authorized Official

Name: DR. MICHAEL NORMAN BAUM
Title or Position: PRESIDENT
Credential: D.C.
Phone: 305-864-1419