Provider Demographics
NPI:1073514436
Name:BAUM, MICHAEL NORMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NORMAN
Last Name:BAUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 71ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3645
Mailing Address - Country:US
Mailing Address - Phone:305-864-1419
Mailing Address - Fax:305-861-7246
Practice Address - Street 1:1175 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3645
Practice Address - Country:US
Practice Address - Phone:305-864-1419
Practice Address - Fax:305-861-7246
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2011-09-09
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
FLCH 3676111N00000X, 171100000X, 111NR0400X, 111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050317700Medicaid
FLT55944Medicare UPIN
FL050317700Medicaid