Provider Demographics
NPI:1194847046
Name:BARBER, ALVAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVAN
Middle Name:WILLIAM
Last Name:BARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3491 S MELLONVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-9607
Mailing Address - Country:US
Mailing Address - Phone:407-625-9486
Mailing Address - Fax:497-328-9486
Practice Address - Street 1:70 FOX RIDGE CT STE B
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-2752
Practice Address - Country:US
Practice Address - Phone:407-625-9486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0062654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF71778Medicare UPIN