Provider Demographics
NPI:1003952938
Name:DEBORAH S. BART, M.D.'S & ASSOC.
Entity Type:Organization
Organization Name:DEBORAH S. BART, M.D.'S & ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:BART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-323-3838
Mailing Address - Street 1:3055 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6705
Mailing Address - Country:US
Mailing Address - Phone:727-323-3838
Mailing Address - Fax:727-323-4520
Practice Address - Street 1:3055 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6705
Practice Address - Country:US
Practice Address - Phone:727-323-3838
Practice Address - Fax:727-323-4520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99219Medicare ID - Type Unspecified