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General NPI Number Information
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NPI Number | 1427666973
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Entity Type | Individual
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Provider Name | BAILEY PETERSON OD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 3880 TAMIAMI TRL N
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City | NAPLES
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State | FL
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Zip | 34103-3504
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Country | US
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Telephone | 239-659-3937
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Fax | 239-659-3984
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Provider Business Mailing Address
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Address Line | 3880 TAMIAMI TRL N
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City | NAPLES
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State | FL
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Zip | 34103-3504
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Country | US
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Telephone | 239-659-3937
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Fax | 239-659-3984
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC005841
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2019021906
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OPC5841
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License Number State | FL
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