MEDICARE: SUZANNE MARCIA BAKER PHARMACIST

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	183500000X	Pharmacist	PS22502	FL

General Provider Information

NPI Number	:	1144567058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE MARCIA BAKER PHARMACIST

Provider Business Mailing Address
First Line	:	7018 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-2292
Country	:	US
Telephone Number	:	813-884-5705
Fax Number	:	813-889-8434

Provider Business Practice Location Address
First Line	:	7018 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-2292
Country	:	US
Telephone Number	:	813-884-5705
Fax Number	:	813-889-8434

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

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	01/11/2013

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