Individual
MADISON BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0110010026
VA
363AS0400X
Surgical Physician Assistant
Primary
PA9120294
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127748700
—
FL
01
—
4TIJS
BCBS
FL
Enumeration date
04/30/2024
Last updated
12/07/2025
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