Healthcare Provider Details

I. General information

NPI: 1518510627
Provider Name (Legal Business Name): ERIN BAILEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 SKYLINE DR STE 1011
LAKE MARY FL
32746-6224
US

IV. Provider business mailing address

45 SKYLINE DR STE 1011
LAKE MARY FL
32746-6224
US

V. Phone/Fax

Practice location:
  • Phone: 407-805-8300
  • Fax:
Mailing address:
  • Phone: 407-805-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS58730
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: