Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO3578 | FL |
NPI | 1003167206 |
---|---|
Provider Name | Dr. Barbara Marie Buckley |
First Address | Venice, FL 34293-1630 |
Second Address | Venice, FL 34293-1630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2012 |
Last Update Date | 18/07/2013 |