Provider Demographics
NPI:1528115888
Name:BAKER, WILLIAM (EDD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4370 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 241
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3412
Mailing Address - Country:US
Mailing Address - Phone:941-926-2474
Mailing Address - Fax:941-926-2440
Practice Address - Street 1:4370 S TAMIAMI TRL
Practice Address - Street 2:SUITE 241
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3412
Practice Address - Country:US
Practice Address - Phone:941-926-2474
Practice Address - Fax:941-926-2440
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5729103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16173471OtherPHCS
FLV213GOtherEMPIRE BCBS
FL2817320OtherAETNA HMO
FL54451OtherMENTAL HEALTH NETWORK
FL7098378OtherAETNA
FL047583OtherVALUE OPTIONS
FL229064OtherCOMPSYCH
FL54451OtherBLUE CROSS BLUE SHIELD
FL54451OtherBLUE CROSS BLUE SHIELD