MEDICARE: JAIME L. BAQUERO, MD, PA

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	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician

General Provider Information

NPI Number	:	1083715742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAIME L. BAQUERO, MD, PA

Provider Business Mailing Address
First Line	:	7070 W PALMETTO PARK RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7070 W PALMETTO PARK RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3411
Country	:	US
Telephone Number	:	561-451-3481
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAIME BAQUERO
Credential	:
Telephone Number	:	561-451-3481

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	08/22/2020

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