Healthcare Provider Details

I. General information

NPI: 1669395505
Provider Name (Legal Business Name): BAILEY BURNETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 FLEMING ST
KEY WEST FL
33040-6529
US

IV. Provider business mailing address

27418 JAMAICA LN
SUMMERLAND KEY FL
33042-5436
US

V. Phone/Fax

Practice location:
  • Phone: 786-929-6162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2833277
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: