Individual
JUSTINE M BAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1509 W ORANGE BLOSSOM TRL, APOPKA, FL 32712-2640
(407) 814-0436
(407) 814-0818
Mailing address
298 MORNING CREEK CIR, APOPKA, FL 32712-8139
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA22221
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184698185
FACILITY NPI FOR MEDICARE
FL
Enumeration date
07/29/2010
Last updated
07/29/2010
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