Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME62531 | FL |
NPI | 1003834219 |
---|---|
Provider Name | Ms. Brenda M Barry |
First Address | Orlando, FL 32814-6651 |
Second Address | Orlando, FL 32814-6651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 19/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E58904 | (02) | FL |