Basic Information
| Provider Information | |||||||||
| NPI: | 1760742803 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 464 SONOMA ISLES CIR | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334785498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545921308 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2007 PALM BEACH LAKES BLVD | ||||||||
| Address2: | MSC 143 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334096501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614208555 | ||||||||
| FaxNumber: | 5614208550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2012 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 005435 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | ME127768 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.