Provider Demographics
NPI:1881492486
Name:RICARDO L. BAEZ PHYSICIAN ASSISTANT IN MEDICINE PLLC.
Entity type:Organization
Organization Name:RICARDO L. BAEZ PHYSICIAN ASSISTANT IN MEDICINE PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:347-853-0915
Mailing Address - Street 1:10454 WATER HYACINTH DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8848
Mailing Address - Country:US
Mailing Address - Phone:646-457-8127
Mailing Address - Fax:
Practice Address - Street 1:1469 ASTOR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5846
Practice Address - Country:US
Practice Address - Phone:646-457-8127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty