Provider Demographics
NPI:1225255540
Name:DR. LEE S. BARBACH, P.A.
Entity Type:Organization
Organization Name:DR. LEE S. BARBACH, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-932-5505
Mailing Address - Street 1:2940 NE 188TH ST
Mailing Address - Street 2:# 111
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2911
Mailing Address - Country:US
Mailing Address - Phone:305-932-5505
Mailing Address - Fax:305-792-6410
Practice Address - Street 1:1125 NE 125TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5034
Practice Address - Country:US
Practice Address - Phone:305-932-5505
Practice Address - Fax:305-792-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88319OtherBCBS
FL88319OtherBCBS