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Individual
KEITH A BAKER
Active
Individual
KEITH A BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS4653
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022489500
—
FL
01
—
82651
BLUE CROSS PROVIDER
FL
01
—
82651V
MEDICARE
FL
Enumeration date
06/02/2006
Last updated
09/30/2020
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