Phung Baxter
Physician Assistant in Lakewood Ranch, FL. Individual provider (NPI-1).
NPI number1336769256
StatusActive
Last updated in NPPESDec 6, 2021
Details
- NPI
- 1336769256
- Entity type
- Individual (NPI-1)
- Name
- Ms. Phung Baxter
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 21, 2020
- Certification date
- Dec 6, 2021
- Last updated
- Dec 6, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 9113083 | FL | Yes |
Practice location
6280 Lake Osprey DrLakewood Ranch, FL 34240-8425
Phone 941-351-5700
Mailing address
6280 Lake Osprey DrLakewood Ranch, FL 34240-8425
Phone 941-351-5700
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