Individual
BAILEY J RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9981 S HEALTHPARK DR, FORT MYERS, FL 33908-3620
(239) 343-5000
Mailing address
9885 MAR LARGO CIR, FORT MYERS, FL 33919-7326
(239) 989-8523
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9570449
FL
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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