1376965665 NPI number — MRS. BARBARA ELLEN ROHR AGPCRN

Table of content: MRS. BARBARA ELLEN ROHR AGPCRN (NPI 1376965665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376965665 NPI number — MRS. BARBARA ELLEN ROHR AGPCRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROHR
Provider First Name:
BARBARA
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AGPCRN
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:
1376965665
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4411 BEE RIDGE ROAD
Provider Second Line Business Mailing Address:
PMB 309
Provider Business Mailing Address City Name:
SARASOTA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-926-6553
Provider Business Mailing Address Fax Number:
941-296-8501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
407 6TH AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRADENTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34208-1927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-749-7997
Provider Business Practice Location Address Fax Number:
941-749-7944
Provider Enumeration Date:
01/06/2014

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: 363L00000X , with the licence number:  ARNP3388122 , 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)





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