Healthcare Provider Details

I. General information

NPI: 1639289101
Provider Name (Legal Business Name): JASON BAKER FIELDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 KING HELIE BLVD
NEW PORT RICHEY FL
34653-1435
US

IV. Provider business mailing address

8002 KING HELIE BLVD
NEW PORT RICHEY FL
34653-1435
US

V. Phone/Fax

Practice location:
  • Phone: 727-841-4200
  • Fax:
Mailing address:
  • Phone: 727-841-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME108713
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberME108713
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: