MEDICARE: AUSTIN CLAY BAKER D.C., LMT

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	111N00000X	Chiropractor	CH15352	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C10QB	OTHER	FL	FLORIDA BLUE

General Provider Information

NPI Number	:	1497194161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN CLAY BAKER D.C., LMT

Provider Business Mailing Address
First Line	:	1832 AFSHIN CT
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-6002
Country	:	US
Telephone Number	:	863-617-8682
Fax Number	:

Provider Business Practice Location Address
First Line	:	3284 COVE BEND DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2752
Country	:	US
Telephone Number	:	863-617-8682
Fax Number	:

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

Provider Enumeration Date	:	06/17/2013
Last Update Date	:	02/24/2026

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