MEDICARE: JEFFREY TRAVIS BAKER JR. D.O.

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	207R00000X	Internal Medicine Physician	OS12833	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	:	1528487808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY TRAVIS BAKER JR. D.O.

Provider Business Mailing Address
First Line	:	18473 SW 89TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33157-7162
Country	:	US
Telephone Number	:	786-490-3004
Fax Number	:	954-634-4292

Provider Business Practice Location Address
First Line	:	959 WEST AVE STE 17
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-5214
Country	:	US
Telephone Number	:	786-490-6200
Fax Number	:	954-634-4293

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	03/04/2025

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