Provider Demographics
NPI:1073567681
Name:BARR, CARL ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:ROBERT
Last Name:BARR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 SAGECREST DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4603
Mailing Address - Country:US
Mailing Address - Phone:407-287-9595
Mailing Address - Fax:
Practice Address - Street 1:615 E PRINCETON ST
Practice Address - Street 2:STE 225
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1456
Practice Address - Country:US
Practice Address - Phone:407-897-3544
Practice Address - Fax:407-897-4016
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS92202084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2699320Medicaid
I17726Medicare UPIN
FL2699320Medicaid