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General NPI Number Information
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NPI Number | 1750628814
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Entity Type | Individual
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Provider Name | TIM BAILEY
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Gender | Male
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Dates
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Enumeration Date | 01/09/2013
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 1600 66TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-5535
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Country | US
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Telephone | 727-344-1286
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Fax | 727-344-1308
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Provider Business Mailing Address
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Address Line | 1518 PINELLAS POINT DR S
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City | ST PETERSBURG
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State | FL
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Zip | 33705-6175
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Country | US
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Telephone | 727-865-6968
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Fax | 727-865-6968
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS24476
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License Number State | FL
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