Basic Information
| Provider Information | |||||||||
| NPI: | 1174749147 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARRY M. MISKIN, MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8068 | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334688068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617482889 | ||||||||
| FaxNumber: | 5617481523 | ||||||||
| Practice Location | |||||||||
| Address1: | 1002 OLD DIXIE HIGHWAY | ||||||||
| Address2: | SUITE 304 | ||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617457789 | ||||||||
| FaxNumber: | 5617457833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 12/17/2009 | ||||||||
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| AuthorizedOfficialLastName: | BARLOW | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER BILLING COMPANY | ||||||||
| AuthorizedOfficialTelephone: | 5617482889 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | ME0051970 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.