Provider Demographics
NPI:1417969239
Name:BAILEY, TREVOR LEVERE (DO)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:LEVERE
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5849 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1347
Mailing Address - Country:US
Mailing Address - Phone:561-264-3396
Mailing Address - Fax:561-210-3080
Practice Address - Street 1:5849 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1347
Practice Address - Country:US
Practice Address - Phone:561-264-3396
Practice Address - Fax:561-210-3080
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104811700Medicaid
FL3308415OtherCOVENTRY