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General NPI Number Information
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NPI Number | 1528694544
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Entity Type | Individual
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Provider Name | JOVAN COLLANTES BAKER MD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2020
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 26800 S TAMIAMI TRL STE 340
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-4355
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Country | US
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Telephone | 239-495-4490
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Fax | 239-468-7923
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-495-4490
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Fax | 239-468-7923
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-16244
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME177331
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License Number State | FL
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