Individual
TERESA BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3515 E FLETCHER AVE, MDC-14, TAMPA, FL 33613-4702
(813) 974-8900
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME123931
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016602200
—
FL
01
—
BHFQE
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/21/2011
Last updated
03/31/2021
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