Provider Demographics
NPI:1992987580
Name:IRA M BAUM DPM PA
Entity type:Organization
Organization Name:IRA M BAUM DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM PA
Authorized Official - Phone:305-598-9454
Mailing Address - Street 1:8940 N KENDALL DR
Mailing Address - Street 2:STE 801E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2148
Mailing Address - Country:US
Mailing Address - Phone:305-598-9454
Mailing Address - Fax:305-598-2884
Practice Address - Street 1:8940 N KENDALL DR
Practice Address - Street 2:STE 801E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2148
Practice Address - Country:US
Practice Address - Phone:305-598-9454
Practice Address - Fax:305-598-2884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1214213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77751OtherMEDICARE GRP
FL0715050001OtherP TAN
FL0715050001OtherP TAN
FL0715050001Medicare UPIN