Provider Demographics
NPI:1033254701
Name:BARON, DON (RPH)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:BARON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12490 WORLD CUP LN
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3502
Mailing Address - Country:US
Mailing Address - Phone:561-208-6450
Mailing Address - Fax:
Practice Address - Street 1:4105 STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-8177
Practice Address - Country:US
Practice Address - Phone:561-433-2192
Practice Address - Fax:561-433-2569
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0020661183500000X
OH03315522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25494100Medicaid
FL0556050917Medicare ID - Type UnspecifiedWINN-DIXIE MEDICARE