MEDICARE: DR. SUSAN RAE BASKIN M.D.

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	261QM2500X	Medical Specialty Clinic/Center	162588	FL

General Provider Information

NPI Number	:	1407178858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN RAE BASKIN M.D.

Provider Business Mailing Address
First Line	:	205 NE 5TH TER
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33444-3866
Country	:	US
Telephone Number	:	561-667-0987
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 NE 5TH TER
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33444-3866
Country	:	US
Telephone Number	:	561-667-0987
Fax Number	:

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

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	01/12/2026

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