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NPI Code Detail

MEDICARE: MAICO JULIAN BAEZ SR. APRN, CNP

MEDICARE: MAICO JULIAN BAEZ SR. APRN, CNP
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
1363L00000XNurse PractitionerAPRN.CNP.0029198OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.0029198OH
3363LA2100XAcute Care Nurse PractitionerAPRN.CNP.0029198OH

General Provider Information

NPI Number : 1710558598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAICO JULIAN BAEZ SR. APRN, CNP
Provider Business Mailing Address
First Line : 6479 HAMILTON MASON RD
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-1375
Country : US
Telephone Number : 513-255-6566
Fax Number :
Provider Business Practice Location Address
First Line : 543 PARK AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45013-3033
Country : US
Telephone Number : 513-737-0257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2021
Last Update Date : 05/30/2025

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