Basic Information
| Provider Information | |||||||||
| NPI: | 1851393664 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAUM | ||||||||
| FirstName: | TINA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | APRN, ACNS-BC, CWON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1395 S PINELLAS AVE | ||||||||
| Address2: | |||||||||
| City: | TARPON SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346893790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7279434111 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1395 S PINELLAS AVE | ||||||||
| Address2: | |||||||||
| City: | TARPON SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346893790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7279425000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2005 | ||||||||
| LastUpdateDate: | 12/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/30/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2200X | APRN9344546 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
No ID Information.