Provider Demographics
NPI:1285449124
Name:BAKER, TAYLOR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
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 1:30841 MIRADA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:FL
Mailing Address - Zip Code:33576-7305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30841 MIRADA BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:FL
Practice Address - Zip Code:33576-7305
Practice Address - Country:US
Practice Address - Phone:352-588-1170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS68202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist