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NPI Code Detail

MEDICARE: MR. RONALD J BAIER L.C.S.W.

MEDICARE: MR. RONALD J BAIER L.C.S.W.
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
11041C0700XClinical Social WorkerSW6150FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z024QOTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1679780589
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RONALD J BAIER L.C.S.W.
Provider Business Mailing Address
First Line : 1342 COLONIAL BLVD
Second Line : SUITE H-64
City : FORT MYERS
State : FL
Zip : 33907-1013
Country : US
Telephone Number : 239-274-0676
Fax Number : 239-274-0675
Provider Business Practice Location Address
First Line : 1342 COLONIAL BLVD
Second Line : SUITE H-64
City : FORT MYERS
State : FL
Zip : 33907-1013
Country : US
Telephone Number : 239-274-0676
Fax Number : 239-274-0675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 05/12/2014

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