Provider Demographics
NPI:1144268632
Name:BADEN, PATRICK ANTHONY (DPT)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ANTHONY
Last Name:BADEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 MEDICAL PARK DRIVE
Mailing Address - Street 2:STE 202
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1225
Mailing Address - Country:US
Mailing Address - Phone:321-953-1212
Mailing Address - Fax:321-768-7829
Practice Address - Street 1:1341 MEDICAL PARK DRIVE
Practice Address - Street 2:STE 202
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1225
Practice Address - Country:US
Practice Address - Phone:321-953-1212
Practice Address - Fax:321-768-7829
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2393ZMedicare PIN