1689854291 NPI number — BARRY UNIVERSITY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689854291 NPI number — BARRY UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARRY UNIVERSITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BARRY UNIVERSITY FOOT & ANKLE INSTITUTE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689854291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11300 NE 2ND AVE
Provider Second Line Business Mailing Address:
PODIATRY
Provider Business Mailing Address City Name:
MIAMI SHORES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33161-6628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-899-4061
Provider Business Mailing Address Fax Number:
305-899-4798

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1090 KANE CONCOURSE
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
BAY HARBOR ISLANDS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33154-2130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-893-9366
Provider Business Practice Location Address Fax Number:
305-893-4408
Provider Enumeration Date:
11/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSOCIATE DEAN OF CLINICS
Authorized Official Telephone Number:
305-899-3252

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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