| Entity Name: | BAUM CHIROPRACTIC CLINIC, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Dec 1982 (42 years ago) |
| Document Number: | G16267 |
| FEI/EIN Number | 592241756 |
| Address: | 1175-71ST STREET, MIAMI BEACH, FL, 33141 |
| Mail Address: | 1175-71ST STREET, MIAMI BEACH, FL, 33141 |
| ZIP code: | 33141 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366650962 | 2007-05-18 | 2011-09-09 | 1175 71ST ST, MIAMI BEACH, FL, 331413645, US | 1175 71ST ST, MIAMI BEACH, FL, 331413645, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-864-1419 |
| Fax | 3058617246 |
Authorized person
| Name | DR. MICHAEL NORMAN BAUM |
| Role | PRESIDENT |
| Phone | 3058641419 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH 3676 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 111NI0013X - Independent Medical Examiner Chiropractor |
| License Number | CH 3676 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 111NR0400X - Rehabilitation Chiropractor |
| License Number | CH 3676 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 171100000X - Acupuncturist |
| License Number | CH 3676 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 050317700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BAUM, MICHAEL | Agent | 1175-71ST ST, MIAMI BEACH, FL, 33141 |
| Name | Role | Address |
|---|---|---|
| BAUM, MICHAEL | President | 1175-71ST STREET, MIAMI BEACH, FL |
| Name | Role | Address |
|---|---|---|
| BAUM, MICHAEL | Secretary | 1175-71ST STREET, MIAMI BEACH, FL |
| Name | Role | Address |
|---|---|---|
| BAUM, MICHAEL | Director | 1175-71ST STREET, MIAMI BEACH, FL |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
