Provider Demographics
NPI:1477564383
Name:BAKER MEDICAL ARTS PA
Entity Type:Organization
Organization Name:BAKER MEDICAL ARTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACOG
Authorized Official - Phone:941-748-6161
Mailing Address - Street 1:5225 MANATEE AV W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3742
Mailing Address - Country:US
Mailing Address - Phone:941-748-6161
Mailing Address - Fax:941-761-4478
Practice Address - Street 1:3651 CORTEZ RD W SUITE 100
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34610-3742
Practice Address - Country:US
Practice Address - Phone:941-748-6161
Practice Address - Fax:941-761-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060728207VG0400X
FLARNP3021212363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33276Medicare ID - Type Unspecified