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Organization

GREGORY N BAILEY PAC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY N BAILEY P.A. (PRESIDENT)
(305) 558-9522
Entity
Organization

Contact information

Practice address
6175 NW 153RD ST, SUITE 301, MIAMI LAKES, FL 33014-2435
(305) 558-9522
(305) 558-9520
Mailing address
6175 NW 153RD ST, SUITE 301, MIAMI LAKES, FL 33014-2435
(305) 558-9522
(305) 558-9520

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9101559
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA 9101559
PROF LICENSE
FL
Enumeration date
09/11/2007
Last updated
09/11/2007
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