Bayouth, Lilly Ann
Bayouth, Lilly Ann is an individual health care provider with primary practice located at 13685 Doctors Way Ste 100 , Fort Myers FL 33912-4337. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is her primary health care specialty. Bayouth, Lilly Ann can be contacted via phone (239) 343-1612.Contact Information
Primary practice address
13685 Doctors Way Ste 100
Fort Myers FL 33912-4337
Phone: (239) 343-1612
Fax: (239) 343-4229
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | ME163279 | Florida |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 2021-01560 | North Carolina |
Profile Details
| NPI number | 1053731133 |
|---|---|
| LBN Legal business name | Bayouth, Lilly Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 16th, 2014 |
| Last updated | Sep 8th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053731133 | NPPES |
| Florida | MEDICAID | 119174900 |
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