MEDICARE: AMBER BAKER RN

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	335E00000X	Prosthetic/Orthotic Supplier
2	163W00000X	Registered Nurse	9622867	FL
3	332B00000X	Durable Medical Equipment & Medical Supplies		FL

General Provider Information

NPI Number	:	1780217174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER BAKER RN

Provider Business Mailing Address
First Line	:	3000 MURRELL RD # 561272
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4431
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 N COURTENAY PKWY UNIT 6
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-5213
Country	:	US
Telephone Number	:	321-914-9980
Fax Number	:

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

Provider Enumeration Date	:	02/13/2020
Last Update Date	:	01/20/2026

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