1881179885 NPI number — BRAIN AND SPINE NEUROSCIENCE INSTITUTE, LLC

Table of content: MR. SCOTT MARTIN BAKER PA (NPI 1649239096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881179885 NPI number — BRAIN AND SPINE NEUROSCIENCE INSTITUTE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRAIN AND SPINE NEUROSCIENCE INSTITUTE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1881179885
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3519 PALM HARBOR BLVD STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM HARBOR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34683-1416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-336-4461
Provider Business Mailing Address Fax Number:
813-336-4466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4728 N HABANA AVE STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33614-7147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-312-4844
Provider Business Practice Location Address Fax Number:
727-312-4841
Provider Enumeration Date:
09/26/2018

Additional Information

Authorized Official

Authorized Official Last Name:
SOLIMAN
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
813-336-4461

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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