Provider Demographics
NPI:1386981975
Name:BALDWIN, MICHAEL DEAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DEAN
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 S RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-7527
Mailing Address - Country:US
Mailing Address - Phone:386-478-1334
Mailing Address - Fax:386-478-1337
Practice Address - Street 1:2970 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-7527
Practice Address - Country:US
Practice Address - Phone:386-478-1334
Practice Address - Fax:386-478-1337
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist