Provider Demographics
NPI:1891417713
Name:ALAI, BAILEY REBECCA (PA-C)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:REBECCA
Last Name:ALAI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:866-400-3376
Mailing Address - Fax:239-561-3763
Practice Address - Street 1:7310 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5503
Practice Address - Country:US
Practice Address - Phone:866-400-3376
Practice Address - Fax:239-561-3763
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9119211363A00000X
MAPA8963363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant