Provider Demographics
NPI:1881728806
Name:BAKER, SCOTT MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:BAKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8618 CARA PARK WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-1633
Mailing Address - Country:US
Mailing Address - Phone:813-854-4172
Mailing Address - Fax:727-232-0129
Practice Address - Street 1:8618 CARA PARK WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-1633
Practice Address - Country:US
Practice Address - Phone:813-854-4172
Practice Address - Fax:727-232-0129
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380799100Medicaid
FL22805OtherBLUE CROSS BLUE SHIELD
FL22805OtherBLUE CROSS BLUE SHIELD