Provider Demographics
NPI:1134360720
Name:BAKER, SUZANNE ANTOINETTE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:ANTOINETTE
Last Name:BAKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:SUZANNE
Other - Middle Name:A
Other - Last Name:PALOMINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:5208 NW 109TH WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2748
Mailing Address - Country:US
Mailing Address - Phone:954-599-2171
Mailing Address - Fax:954-584-2274
Practice Address - Street 1:5208 NW 109TH WAY
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-2748
Practice Address - Country:US
Practice Address - Phone:954-599-2171
Practice Address - Fax:954-584-2274
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN91851171041C0700X, 363LP0808X
ZZARNP9185117363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00811339OtherRAILROAD MEDICARE
FLBQ280ZMedicare PIN