Provider Demographics
NPI:1093226276
Name:BAKER, CAMILLE MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16558 NE 26TH AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4018
Mailing Address - Country:US
Mailing Address - Phone:562-221-6888
Mailing Address - Fax:
Practice Address - Street 1:5701 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6022
Practice Address - Country:US
Practice Address - Phone:305-625-0952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist