=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558446567
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEST PSYCHIATRIC ASSOCIATES P A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2006
-----------------------------------------------------
Last Update Date | 09/12/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 N HIATUS RD SUITE 201
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33026-5207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-499-2535
-----------------------------------------------------
Fax | 954-435-6614
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 N HIATUS RD SUITE 201
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33026-5207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-499-2535
-----------------------------------------------------
Fax | 954-435-6614
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SAYONARA J BAEZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 954-499-2535
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | ME75024
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------