Provider Demographics
NPI:1497965883
Name:BAIATA, RICHARD NICHOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NICHOLAS
Last Name:BAIATA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 ATLANTIC BLVD
Mailing Address - Street 2:UNIT 8
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-4026
Mailing Address - Country:US
Mailing Address - Phone:917-204-4166
Mailing Address - Fax:
Practice Address - Street 1:469 ATLANTIC BLVD
Practice Address - Street 2:UNIT 8
Practice Address - City:ATLANTIC BEACH
Practice Address - State:FL
Practice Address - Zip Code:32233-4026
Practice Address - Country:US
Practice Address - Phone:904-241-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011135111N00000X
FLCH 10325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor