MEDICARE: NOELA JEAN BAPTISTE

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	363AM0700X	Medical Physician Assistant	000146-P.A.	PR

General Provider Information

NPI Number	:	1063168235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOELA JEAN BAPTISTE

Provider Business Mailing Address
First Line	:	18831 NE 3RD CT APT 523
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-3867
Country	:	US
Telephone Number	:	786-901-3914
Fax Number	:

Provider Business Practice Location Address
First Line	:	18831 NE 3RD CT APT 523
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-3867
Country	:	US
Telephone Number	:	786-901-3914
Fax Number	:

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

Provider Enumeration Date	:	02/26/2022
Last Update Date	:	02/26/2022

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