MEDICARE: JOHN BAKER 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	207X00000X	Orthopaedic Surgery Physician	ME31990	FL

General Provider Information

NPI Number	:	1417943531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN BAKER MD PA

Provider Business Mailing Address
First Line	:	4519 GEORGE RD
Second Line	:	STE. 100
City	:	TAMPA
State	:	FL
Zip	:	33634-7329
Country	:	US
Telephone Number	:	813-496-1075
Fax Number	:

Provider Business Practice Location Address
First Line	:	2919 W SWANN AVE
Second Line	:	STE. 301
City	:	TAMPA
State	:	FL
Zip	:	33609-4038
Country	:	US
Telephone Number	:	813-877-4123
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN BAKER
Credential	:	MD
Telephone Number	:	813-877-4123

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	08/22/2020

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