Provider Demographics
NPI:1134391204
Name:BAKER, JOSH BROOKS (RPH)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:BROOKS
Last Name:BAKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 W GANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-2607
Mailing Address - Country:US
Mailing Address - Phone:813-831-3050
Mailing Address - Fax:813-839-6764
Practice Address - Street 1:3615 W GANDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-2607
Practice Address - Country:US
Practice Address - Phone:813-831-3050
Practice Address - Fax:813-839-6764
Is Sole Proprietor?:No
Enumeration Date:2008-03-29
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist