Provider Demographics
NPI:1003167206
Name:BUCKLEY, BARBARA MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:MARIE
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:MARIE
Other - Last Name:BORAGGINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 SHAMROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1630
Mailing Address - Country:US
Mailing Address - Phone:941-497-7473
Mailing Address - Fax:
Practice Address - Street 1:115 SHAMROCK BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1630
Practice Address - Country:US
Practice Address - Phone:941-497-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3578213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery