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NPI 1760742803

NPI 1760742803 : MICHELLE LEE BAKER MD : WEST PALM BEACH, FL

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General NPI Number Information
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    NPI Number           |    1760742803
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    Entity Type          |    Individual 
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    Provider Name        |    MICHELLE LEE BAKER MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/23/2012
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    Last Update Date     |    01/18/2022
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Provider Practice Location Address
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    Address Line         |    2007 PALM BEACH LAKES BLVD MSC 143
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    City                 |    WEST PALM BEACH
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    State                |    FL
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    Zip                  |    33409-6501
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    Country              |    US
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    Telephone            |    561-420-8555
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    Fax                  |    561-420-8550
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Provider Business Mailing Address
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    Address Line         |    464 SONOMA ISLES CIR 
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    City                 |    JUPITER
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    State                |    FL
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    Zip                  |    33478-5498
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    Country              |    US
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    Telephone            |    954-592-1308
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    005435
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    License Number State |    GA
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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       |    ME127768
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    License Number State |    FL
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