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NPI Code Detail

MEDICARE: PENNY BAKER

MEDICARE: PENNY BAKER
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
1225200000XPhysical Therapy Assistant19959FL

General Provider Information

NPI Number : 1588510457
Entity Type Code : Individual
Provider Name (Legal Business Name) : PENNY BAKER
Provider Business Mailing Address
First Line : 2140 MORROW ST
Second Line :
City : LAKELAND
State : FL
Zip : 33815-3534
Country : US
Telephone Number : 863-619-2102
Fax Number :
Provider Business Practice Location Address
First Line : 3110 OAKBRIDGE BLVD E
Second Line :
City : LAKELAND
State : FL
Zip : 33803-5987
Country : US
Telephone Number : 863-619-2102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ PENNY BAKER ” Practice Location

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