Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN21733 | FL |
Y | 207YS0123X | Facial Plastic Surgeon | ME149915 | FL |
NPI | 1154717999 |
---|---|
Provider Name | Dr. Phillip Barbee |
First Address | Melbourne, FL 32935-5958 |
Second Address | Satellite Beach, FL 32937-3333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 08/02/2022 |