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Individual

MR. BRIAN M BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 971-6000
(813) 615-7590
Mailing address
12479 TELECOM DR, TAMPA, FL 33637-0913
(813) 972-4199
(813) 972-5753

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E1775V
BCBS OF FLORIDA
FL
Enumeration date
05/18/2006
Last updated
11/05/2007
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