Healthcare Provider Details

I. General information

NPI: 1144937756
Provider Name (Legal Business Name): DR M BAILEY SUAREZ DC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 STATE ROAD 13 STE 9
FRUIT COVE FL
32259-2822
US

IV. Provider business mailing address

445 STATE ROAD 13 STE 9
FRUIT COVE FL
32259-2822
US

V. Phone/Fax

Practice location:
  • Phone: 904-429-7490
  • Fax:
Mailing address:
  • Phone: 904-429-7490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAELE BAILEY SUAREZ
Title or Position: OWNER
Credential: DC DICCP
Phone: 904-429-7490