Provider Demographics
NPI:1578526273
Name:BAILEY, ANABETSY C (ARNP)
Entity Type:Individual
Prefix:
First Name:ANABETSY
Middle Name:C
Last Name:BAILEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11880 SW 40TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3584
Mailing Address - Country:US
Mailing Address - Phone:305-223-8808
Mailing Address - Fax:305-223-8974
Practice Address - Street 1:100 NE 15TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4581
Practice Address - Country:US
Practice Address - Phone:305-245-1100
Practice Address - Fax:305-245-0852
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3072112207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL300754500Medicaid
FLE1486YOtherMEDICARE
FLE1486XOtherMEDICARE
FL300754500Medicaid