Provider Demographics
NPI:1982861308
Name:HUSEVA BAILOR, KATSIARYNA SERHEEUNA (MD)
Entity Type:Individual
Prefix:
First Name:KATSIARYNA
Middle Name:SERHEEUNA
Last Name:HUSEVA BAILOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 37TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6550
Mailing Address - Country:US
Mailing Address - Phone:772-562-2400
Mailing Address - Fax:772-569-3208
Practice Address - Street 1:1255 37TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6550
Practice Address - Country:US
Practice Address - Phone:772-562-2400
Practice Address - Fax:772-569-3208
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1237992082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck