Provider Demographics
NPI:1285622852
Name:BAILEY, DEBRA L (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:L
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 VANDERBILT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2760
Mailing Address - Country:US
Mailing Address - Phone:239-444-3376
Mailing Address - Fax:239-316-3001
Practice Address - Street 1:2350 VANDERBILT BEACH RD
Practice Address - Street 2:SUITE 301
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2760
Practice Address - Country:US
Practice Address - Phone:239-444-3376
Practice Address - Fax:239-316-3001
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041689207N00000X
FLME106898207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHW772YMedicare UPIN
MD721LMedicare PIN
MD488701800Medicaid