Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 002032 | GA |
N | 111NI0900X | Internist | 002032 | GA |
N | 207RC0000X | Internist - Cardiovascular Disease | ME 112264 | FL |
Y | 207RI0011X | Interventional Cardiology | ME 112264 | FL |
NPI | 1013191105 |
---|---|
Provider Name | Ilie Toma Barb |
First Address | Gainesville, FL 32605-4524 |
Second Address | Gainesville, FL 32605-4524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/12/2007 |
Last Update Date | 18/10/2016 |