Individual
CARLA RENEE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10973 SE 175TH PL STE 100, SUMMERFIELD, FL 34491-0905
(352) 259-6553
(352) 873-9397
Mailing address
10973 SE 175TH PL STE 100, SUMMERFIELD, FL 34491-0905
(352) 259-6553
(352) 873-9397
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105058
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009035300
—
FL
Enumeration date
12/08/2009
Last updated
11/05/2024
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