Provider Demographics
NPI:1164139432
Name:CASIMIR, BARBARA (RN/ ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CASIMIR
Suffix:
Gender:F
Credentials:RN/ ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2977 GOODLETTE-FRANK RD N STE 1
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4613
Mailing Address - Country:US
Mailing Address - Phone:239-331-3548
Mailing Address - Fax:239-842-6182
Practice Address - Street 1:2977 GOODLETTE-FRANK RD N STE 1
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4613
Practice Address - Country:US
Practice Address - Phone:239-331-3548
Practice Address - Fax:239-842-6182
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9422161163WA2000X
FL30212294163WH0200X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115085300Medicaid