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General NPI Number Information
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NPI Number | 1124091228
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Entity Type | Individual
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Provider Name | RAYMOND C BAEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1317 W POINT DR
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City | COCOA
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State | FL
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Zip | 32922-6464
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Country | US
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Telephone | 321-636-4808
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Fax | 321-631-9436
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Provider Business Mailing Address
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Address Line | 1317 W POINT DR
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City | COCOA
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State | FL
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Zip | 32922-6464
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Country | US
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Telephone | 321-324-0434
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Fax | 321-735-4080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0049952
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License Number State | FL
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