Healthcare Provider Details

I. General information

NPI: 1629251616
Provider Name (Legal Business Name): ROBERT J BAKER III AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 10/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8831 IMMOKALEE RD
NAPLES FL
34120
US

IV. Provider business mailing address

7301 W COUNTRY CLUB DR N APT 110
SARASOTA FL
34243-4504
US

V. Phone/Fax

Practice location:
  • Phone: 239-963-0235
  • Fax:
Mailing address:
  • Phone: 415-515-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2203
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: