MEDICARE: DR. DESIREE BAKER PHARMD

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	PS52351	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	:	1396118873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DESIREE BAKER PHARMD

Provider Business Mailing Address
First Line	:	3208 2ND AVE N
Second Line	:	STE 4
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-3682
Country	:	US
Telephone Number	:	561-651-9393
Fax Number	:	561-530-4968

Provider Business Practice Location Address
First Line	:	3208 2ND AVE N
Second Line	:	STE 4
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-3682
Country	:	US
Telephone Number	:	561-651-9393
Fax Number	:	561-530-4968

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

Provider Enumeration Date	:	11/05/2015
Last Update Date	:	11/05/2015

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