MEDICARE: MORGAN H. BAEDER LCSW

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	1041C0700X	Clinical Social Worker		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SW21211	OTHER	FL	FLORIDA DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1760097414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN H. BAEDER LCSW

Provider Business Mailing Address
First Line	:	2806 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2653
Country	:	US
Telephone Number	:	813-264-9955
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 HARRISON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2725
Country	:	US
Telephone Number	:	813-863-1297
Fax Number	:

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

Provider Enumeration Date	:	09/10/2020
Last Update Date	:	09/05/2024

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