Provider Demographics
NPI:1992957260
Name:BAKER, ALEXIA ELIZABETH
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:ELIZABETH
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15409 BAMA BREEZE LN
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-2217
Mailing Address - Country:US
Mailing Address - Phone:813-758-7331
Mailing Address - Fax:813-633-5960
Practice Address - Street 1:15409 BAMA BREEZE LN
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-2217
Practice Address - Country:US
Practice Address - Phone:813-758-7331
Practice Address - Fax:813-633-5960
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL372600000X, 372500000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker