Provider Demographics
NPI:1881699718
Name:BAKER, ROBIN A (MD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:A
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 AVENUE K SE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-4146
Mailing Address - Country:US
Mailing Address - Phone:863-294-4404
Mailing Address - Fax:863-294-1059
Practice Address - Street 1:400 AVENUE K SE
Practice Address - Street 2:STE 11
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4145
Practice Address - Country:US
Practice Address - Phone:863-294-4404
Practice Address - Fax:863-294-1059
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38099207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064644000Medicaid
FL53634Medicare ID - Type Unspecified
FL64644000Medicaid