Individual
LILLY ANN BAYOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13685 DOCTORS WAY STE 100, FORT MYERS, FL 33912-4337
(239) 343-1612
(239) 343-4229
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-1612
(239) 343-4229
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2021-01560
NC
2086S0127X
Trauma Surgery Physician
Primary
ME163279
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119174900
—
FL
Enumeration date
04/16/2014
Last updated
09/08/2023
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