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General NPI Number Information
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NPI Number | 1750941134
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Entity Type | Individual
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Provider Name | RICARDO BAILEY MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 01/14/2024
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Provider Practice Location Address
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Address Line | 1803 MICCOSUKEE COMMONS DR STE 202
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7403
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Country | US
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Telephone | 850-702-9426
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Fax | 850-755-5978
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Provider Business Mailing Address
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Address Line | 1803 MICCOSUKEE COMMONS DR STE 202
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7403
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Country | US
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Telephone | 850-702-9426
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Fax | 850-755-5978
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME149793
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License Number State | FL
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