Provider Demographics
NPI:1700116662
Name:BAUM, LAURA D (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:D
Last Name:BAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2300 GLADES RD
Mailing Address - Street 2:SUITE 305 EAST
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7386
Mailing Address - Country:US
Mailing Address - Phone:561-395-0845
Mailing Address - Fax:561-218-1773
Practice Address - Street 1:2300 GLADES RD
Practice Address - Street 2:SUITE 305 EAST
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7386
Practice Address - Country:US
Practice Address - Phone:561-395-0845
Practice Address - Fax:561-218-1773
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 604692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology