Andrew Baker
Individual provider Active NPI Physical Therapy Clinic/Center · Lake City, FL
NPI 1124664966 · NPPES record last updated Nov 26, 2019
Key facts
- NPI
- 1124664966
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- PTA27903 (FL)
- Practice address
- 945 SW Main Blvd
Lake City, FL 32025-5746 - Phone
- (386) 755-3164
- NPI assigned
- Nov 26, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA27903 | FL | MD | Physical Therapy Clinic/Center |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | PTA27903 | FL | Yes |
Addresses
Primary practice location
945 SW Main Blvd
Lake City, FL 32025-5746
Mailing address
945 SW Main Blvd
Lake City, FL 32025-5746
Phone (386) 755-3164
Other providers in Lake City, FL
- Akeidria Bailey
- Emily Bailey
- Hillary Bailey
- Michelle Rene Bailey
- Patricia Lynn Bailey
- Dessie Lorine Baker
- Edna Baker
- Katrina R Baker
- Robert Steven Baker
- Robert B Balbis
All providers in Lake City, FL · Physical Therapy Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.