MEDICARE: DR. TREVOR LEVERE BAILEY D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS9465	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417969239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TREVOR LEVERE BAILEY D.O.

Provider Business Mailing Address
First Line	:	5849 S CONGRESS AVE
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462-1347
Country	:	US
Telephone Number	:	561-264-3396
Fax Number	:	561-210-3080

Provider Business Practice Location Address
First Line	:	5849 S CONGRESS AVE
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462-1347
Country	:	US
Telephone Number	:	561-264-3396
Fax Number	:	561-210-3080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	06/30/2023

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