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Individual

HOWARD A BAKER III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 HEALTHPARK BLVD, SUITE 1000, ST AUGUSTINE, FL 32086
(904) 810-1045
(904) 810-1046
Mailing address
PO BOX 348, ST AUGUSTINE, FL 32085-0348
(904) 810-1045
(904) 810-1046

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME45744
FL
207RC0000X
Cardiovascular Disease Physician
Primary
ME45744
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0636515100
FL
01
P00429786
RAILROAD MEDICARE
FL
Enumeration date
02/22/2006
Last updated
05/23/2013
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