MEDICARE: DR. NORBERTO BAEZ M.D.

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	207X00000X	Orthopaedic Surgery Physician	13550	PR

General Provider Information

NPI Number	:	1992793970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORBERTO BAEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1019
Second Line	:
City	:	SABANA GRANDE
State	:	PR
Zip	:	00637-1019
Country	:	US
Telephone Number	:	787-831-0181
Fax Number	:	787-831-0181

Provider Business Practice Location Address
First Line	:	770 AVE HOSTOS
Second Line	:	POLICLINICA BELLA VISTA SUITE 104
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1538
Country	:	US
Telephone Number	:	787-831-0181
Fax Number	:	787-831-0181

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	11/25/2014

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