Provider Demographics
NPI:1346228798
Name:BAUM, IRA M (DPM)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:M
Last Name:BAUM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 N KENDALL DR
Mailing Address - Street 2:#801E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176
Mailing Address - Country:US
Mailing Address - Phone:305-598-9454
Mailing Address - Fax:305-598-2884
Practice Address - Street 1:8940 N KENDALL DR
Practice Address - Street 2:#801E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-598-9454
Practice Address - Fax:305-598-2884
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPD0001214213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T85774Medicare UPIN
FL87674Medicare UPIN