Basic Information
| Provider Information | |||||||||
| NPI: | 1326440272 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAIG | ||||||||
| FirstName: | MARYA | ||||||||
| MiddleName: | FATIMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14690 SPRING HILL DR STE 305 | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346098102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527990046 | ||||||||
| FaxNumber: | 3527990115 | ||||||||
| Practice Location | |||||||||
| Address1: | 14391 SPRING HILL DR STE 525 | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346098199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523974292 | ||||||||
| FaxNumber: | 3523974298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2014 | ||||||||
| LastUpdateDate: | 03/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | ARNP9312091 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 363L00000X | ARNP9312091 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | Y0NY4 | 01 | FL | BCBS | OTHER | 013565100 | 05 | FL | MEDICAID |