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General NPI Number Information
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NPI Number | 1316502735
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Entity Type | Individual
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Provider Name | MS. TABITHA LEONDRA BAILEY
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Gender | Female
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Dates
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Enumeration Date | 05/01/2019
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 1710 KENDRICK LN
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City | LAKELAND
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State | FL
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Zip | 33805-2506
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Country | US
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Telephone | 863-262-8857
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Fax | 863-284-1070
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Provider Business Mailing Address
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Address Line | 1710 KENDRICK LN
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City | LAKELAND
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State | FL
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Zip | 33805-2506
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Country | US
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Telephone | 863-262-8857
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Fax | 863-284-1070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | FL
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