Provider Demographics
NPI:1083930655
Name:BARRIS, JOANNA PATRICIA (DO)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:PATRICIA
Last Name:BARRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:PATRICIA
Other - Last Name:COONRADT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 TAMPA GENERAL CIR
Practice Address - Street 2:F170
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-844-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12526207R00000X, 208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL148UROtherBLUE CROSS BLUE SHIELD
FL012202300Medicaid
FL148UROtherBLUE CROSS BLUE SHIELD
FLHU815ZMedicare PIN