Provider Demographics
NPI:1801831409
Name:BASKIN, VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:BASKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 NE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-2009
Mailing Address - Country:US
Mailing Address - Phone:954-763-2030
Mailing Address - Fax:954-763-9847
Practice Address - Street 1:871 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1731
Practice Address - Country:US
Practice Address - Phone:954-567-7141
Practice Address - Fax:954-565-5624
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1249092084P0804X
MI0785472084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry