Provider Demographics
NPI:1033269733
Name:BARNES, VIRGINIA (LMT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:13918 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-4543
Mailing Address - Country:US
Mailing Address - Phone:727-593-9438
Mailing Address - Fax:
Practice Address - Street 1:13918 106TH AVE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-4543
Practice Address - Country:US
Practice Address - Phone:727-593-9438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA11662225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist