Provider Demographics
NPI:1497779474
Name:BAQUERO, JAIME L (MD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:L
Last Name:BAQUERO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5955 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2423
Mailing Address - Country:US
Mailing Address - Phone:305-661-1515
Mailing Address - Fax:305-663-5948
Practice Address - Street 1:9980 CENTRAL PARK BLVD N
Practice Address - Street 2:SUITE 122
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1762
Practice Address - Country:US
Practice Address - Phone:561-470-6177
Practice Address - Fax:561-558-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2015-05-28
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Provider Licenses
StateLicense IDTaxonomies
FLME585052084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology