Healthcare Provider Details

I. General information

NPI: 1376296772
Provider Name (Legal Business Name): BRITTANY BILES PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SW ARCHER RD
GAINESVILLE FL
32608-1136
US

IV. Provider business mailing address

PO BOX 100165
GAINESVILLE FL
32610-0165
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6617
  • Fax: 352-273-6156
Mailing address:
  • Phone: 352-273-6617
  • Fax: 352-273-6156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY11382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: