1902839616 NPI number — CARMEN I BARRES MD

Table of content: CARMEN I BARRES MD (NPI 1902839616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902839616 NPI number — CARMEN I BARRES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRES
Provider First Name:
CARMEN
Provider Middle Name:
I
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1902839616
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2147
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33902-2147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-343-9470
Provider Business Mailing Address Fax Number:
239-343-9498

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8960 COLONIAL CENTER DR
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-303-0926
Provider Business Practice Location Address Fax Number:
239-303-0927
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME0059474 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 253507600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 32325 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com