Provider Demographics
NPI:1144567058
Name:BAKER, SUZANNE MARCIA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARCIA
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7018 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2292
Mailing Address - Country:US
Mailing Address - Phone:813-884-5705
Mailing Address - Fax:813-889-8434
Practice Address - Street 1:7018 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2292
Practice Address - Country:US
Practice Address - Phone:813-884-5705
Practice Address - Fax:813-889-8434
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS22502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist