Provider Demographics
NPI:1609882414
Name:BAITNER, AVI C (MD)
Entity Type:Individual
Prefix:MR
First Name:AVI
Middle Name:C
Last Name:BAITNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 557367
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33255-7367
Mailing Address - Country:US
Mailing Address - Phone:786-624-5845
Mailing Address - Fax:786-624-2688
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:ORTHO DEPARTMENT
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-662-8366
Practice Address - Fax:305-663-9494
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME96400207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276012600Medicaid
FLK6961Medicare UPIN
FL276012600Medicaid