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General NPI Number Information
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NPI Number | 1245763101
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Entity Type | Individual
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Provider Name | JOHN WILLIAM BAUTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1800 SE TIFFANY AVE
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7521
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Country | US
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Telephone | 772-335-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 110 HILLCREST TER
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City | STUART
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State | FL
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Zip | 34996-6729
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Country | US
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Telephone | 317-225-3365
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME170869
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 31148
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License Number State | NE
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