Provider Demographics
NPI:1659339430
Name:BAECHLER, VERONICA RUIZ (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:RUIZ
Last Name:BAECHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W GORE ST STE 405
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1049
Mailing Address - Country:US
Mailing Address - Phone:321-841-9340
Mailing Address - Fax:321-841-9344
Practice Address - Street 1:100 W GORE ST STE 405
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1049
Practice Address - Country:US
Practice Address - Phone:321-841-9340
Practice Address - Fax:321-841-9344
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042850A2080P0006X
FLME1596422080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116279300Medicaid