Virgil Wayne Baker, BC-HIS

Individual provider Active NPI Hearing Instrument Specialist · Bunnell, FL

NPI 1366939217 · NPPES record last updated Apr 17, 2018

Key facts

NPI
1366939217
Entity type
Individual (NPI type 1)
Primary specialty
Hearing Instrument Specialist 237700000X
License
AS2907 (FL)
Practice address
4750 E. Moody Blvd
Suite # 105
Bunnell, FL 32110-7710
Phone
(386) 263-2833
Fax
(386) 313-5134
NPI assigned
Apr 17, 2018
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AS2907FLMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetie Peetie LLC Hearing Instrument Specialist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X AS2907 FL Yes

Addresses

Primary practice location

4750 E. Moody Blvd
Suite # 105
Bunnell, FL 32110-7710

Mailing address

4750 E. Moody Blvd
Suite # 105
Bunnell, FL 32110-7710
Phone (386) 263-2833

Other providers in Bunnell, FL

All providers in Bunnell, FL · Hearing Instrument Specialist in Florida

Sources for this page

Verify at the official NPI Registry.