Provider Demographics
NPI:1144937756
Name:DR M BAILEY SUAREZ DC PLLC
Entity type:Organization
Organization Name:DR M BAILEY SUAREZ DC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAELE
Authorized Official - Middle Name:BAILEY
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC DICCP
Authorized Official - Phone:904-429-7490
Mailing Address - Street 1:445 STATE ROAD 13 STE 9
Mailing Address - Street 2:
Mailing Address - City:FRUIT COVE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-2822
Mailing Address - Country:US
Mailing Address - Phone:904-429-7490
Mailing Address - Fax:
Practice Address - Street 1:445 STATE ROAD 13 STE 9
Practice Address - Street 2:
Practice Address - City:FRUIT COVE
Practice Address - State:FL
Practice Address - Zip Code:32259-2822
Practice Address - Country:US
Practice Address - Phone:904-429-7490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty