MEDICARE: DR. BRANDI JANECE BAKER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	2019006016	MO
2	2084N0400X	Neurology Physician	ME144949	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003298852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDI JANECE BAKER MD

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY
Second Line	:	DOOR D
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5685
Fax Number	:	954-985-7074

Provider Business Practice Location Address
First Line	:	17180 ROYAL PALM BLVD STE 1
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-2394
Country	:	US
Telephone Number	:	954-276-1474
Fax Number	:	954-285-6026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2015
Last Update Date	:	03/16/2021

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