Provider Demographics
NPI:1225071632
Name:BARTA, JOSEPH DONALD (DPM)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DONALD
Last Name:BARTA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5463 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1110
Mailing Address - Country:US
Mailing Address - Phone:352-596-3338
Mailing Address - Fax:352-597-3986
Practice Address - Street 1:5463 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1110
Practice Address - Country:US
Practice Address - Phone:352-596-3338
Practice Address - Fax:352-597-3986
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1749213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029652000Medicaid
FL1083892418OtherFLORIDA FOOT CARE
FL029652000Medicaid
FL87955Medicare ID - Type Unspecified
FL1083892418OtherFLORIDA FOOT CARE