Healthcare Provider Details

I. General information

NPI: 1821335209
Provider Name (Legal Business Name): FRANK ALBERTO BAEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2013
Last Update Date: 07/21/2022
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 NW 9TH AVE
MIAMI FL
33136-1409
US

IV. Provider business mailing address

15170 SW 15TH ST
MIAMI FL
33194-2658
US

V. Phone/Fax

Practice location:
  • Phone: 305-355-7147
  • Fax: 305-355-7324
Mailing address:
  • Phone: 305-803-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number126277
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: