Provider Demographics
NPI:1750514899
Name:BAXLEY, MICHAEL NEAL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NEAL
Last Name:BAXLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:10050 NW 131ST ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1658
Practice Address - Country:US
Practice Address - Phone:904-891-6913
Practice Address - Fax:786-953-7060
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00691902083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine