Provider Demographics
NPI:1346519402
Name:BAKER, TAMMIE (RPH)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242-1400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-900-6697
Practice Address - Street 1:5040 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34242-1400
Practice Address - Country:US
Practice Address - Phone:941-564-5742
Practice Address - Fax:888-900-6697
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLPS29001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst