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General NPI Number Information
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NPI Number | 1750494555
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Entity Type | Individual
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Provider Name | ROSAURA E BAEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 4125 S TAMIAMI TRL STE 2
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City | VENICE
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State | FL
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Zip | 34293-5121
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Country | US
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Telephone | 941-584-9201
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Fax | 941-584-9202
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Provider Business Mailing Address
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Address Line | 4125 S TAMIAMI TRL STE 2
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City | VENICE
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State | FL
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Zip | 34293-5121
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Country | US
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Telephone | 941-584-9201
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Fax | 941-584-9202
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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 | ME92347
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License Number State | FL
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