Healthcare Provider Details

I. General information

NPI: 1588849160
Provider Name (Legal Business Name): BAILEY CHIROPRACTIC LIFE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14867 S DIXIE HWY
MIAMI FL
33176-7928
US

IV. Provider business mailing address

224 SOUTH PARK CIR EAST
ST. AUGUSTINE FL
32086
US

V. Phone/Fax

Practice location:
  • Phone: 305-971-0302
  • Fax: 305-971-8222
Mailing address:
  • Phone: 904-342-4941
  • Fax: 904-342-4937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7429
License Number StateFL

VIII. Authorized Official

Name: DR. JASON ARNOLD BAILEY
Title or Position: CHIROPRATOR
Credential: DC
Phone: 904-342-4941