MEDICARE: MISS AMY BAEZ OTR/L

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	225X00000X	Occupational Therapist	9623	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	:	1043208747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS AMY BAEZ OTR/L

Provider Business Mailing Address
First Line	:	14311 BISCAYNE BLVD # 803
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33261-3479
Country	:	US
Telephone Number	:	786-529-8847
Fax Number	:	305-949-5480

Provider Business Practice Location Address
First Line	:	2050 NE 140TH ST APT 19
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33181-1653
Country	:	US
Telephone Number	:	786-529-8847
Fax Number	:	305-949-5480

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	04/30/2020

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