Provider Demographics
NPI:1609841287
Name:BAKER, JOHN E (M D)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:BAKER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CONGRESS PARK DR
Mailing Address - Street 2:STE 160
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4707
Mailing Address - Country:US
Mailing Address - Phone:561-330-4358
Mailing Address - Fax:561-330-4390
Practice Address - Street 1:190 CONGRESS PARK DR STE 160
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4707
Practice Address - Country:US
Practice Address - Phone:561-330-4358
Practice Address - Fax:561-330-4390
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86962207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5606195Medicaid
FL5606195Medicaid
FLAG700ZMedicare PIN