MEDICARE: MS. ROSALBA BAEZ PA-C

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	363A00000X	Physician Assistant	3252	AZ

General Provider Information

NPI Number	:	1992836852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSALBA BAEZ PA-C

Provider Business Mailing Address
First Line	:	9338 E SHARON DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-7425
Country	:	US
Telephone Number	:	602-397-4747
Fax Number	:

Provider Business Practice Location Address
First Line	:	5201 N 19TH AVE
Second Line	:	STE 121
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2951
Country	:	US
Telephone Number	:	602-433-1822
Fax Number	:

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

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	03/07/2023

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