Provider Demographics
NPI:1578934188
Name:BAUM, HOWARD W III
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:W
Last Name:BAUM
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 COLONIAL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7647
Mailing Address - Country:US
Mailing Address - Phone:813-760-7165
Mailing Address - Fax:
Practice Address - Street 1:3013 COLONIAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7647
Practice Address - Country:US
Practice Address - Phone:813-760-7165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 14058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health