Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME75196 | FL |
N | 207PE0004X | Emergency Medical Services | ME75196 | FL |
NPI | 1093797813 |
---|---|
Provider Name | Steven Mark Barrett |
First Address | Orlando, FL 32837-6803 |
Second Address | Lakeland, FL 33805-3029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 24/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
254092400 | (05) | FL |
D88925 | (02) |