Provider Demographics
NPI:1073739744
Name:BARRE, JULIE GLADDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:GLADDEN
Last Name:BARRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 BAHIA VISTA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2640
Mailing Address - Country:US
Mailing Address - Phone:941-951-2663
Mailing Address - Fax:941-552-3312
Practice Address - Street 1:2750 BAHIA VISTA ST STE 100
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-951-2663
Practice Address - Fax:941-552-3312
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113472207X00000X, 207XX0005X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGP262YMedicare PIN
FLGP262XMedicare PIN