Provider Demographics
NPI:1003819830
Name:ARONSON, BARRY A (OD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:A
Last Name:ARONSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11402 GEORGETOWN CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-1561
Mailing Address - Country:US
Mailing Address - Phone:813-383-6977
Mailing Address - Fax:413-793-8724
Practice Address - Street 1:11402 GEORGETOWN CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-1561
Practice Address - Country:US
Practice Address - Phone:813-383-6977
Practice Address - Fax:413-793-8724
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3454/T342152W00000X
FLOP 1619152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0479950Medicaid
OHAR0509425Medicare ID - Type Unspecified
OH0479950Medicaid