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General NPI Number Information
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NPI Number | 1841165156
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Entity Type | Individual
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Provider Name | RYAN BAKER
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Gender | Male
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 601 S STATE ROAD 7
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City | PLANTATION
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State | FL
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Zip | 33317-4054
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Country | US
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Telephone | 954-321-2296
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Fax | 954-321-5399
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Provider Business Mailing Address
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Address Line | 601 S STATE ROAD 7
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City | PLANTATION
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State | FL
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Zip | 33317-4054
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Country | US
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Telephone | 954-321-2296
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Fax | 954-321-5399
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH24700
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License Number State | FL
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