Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | ME0062067 | FL |
NPI | 1003812207 |
---|---|
Provider Name | Mary F Barber |
First Address | Summerfield, FL 34491-8983 |
Second Address | Summerfield, FL 34491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 25/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
372699100 | (05) | FL |
F36958 | (02) | FL |