Provider Demographics
NPI:1215184031
Name:ALICE R. BARBA MD PA
Entity Type:Organization
Organization Name:ALICE R. BARBA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BARBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-573-7200
Mailing Address - Street 1:4770 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 1140
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137
Mailing Address - Country:US
Mailing Address - Phone:305-573-7200
Mailing Address - Fax:305-573-7092
Practice Address - Street 1:4770 BISCAYBE BLVD
Practice Address - Street 2:SUITE 1140
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137
Practice Address - Country:US
Practice Address - Phone:305-573-7200
Practice Address - Fax:305-573-7092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82656174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3601CMedicare PIN
FLH49323Medicare UPIN
FLE3601BMedicare PIN