Provider Demographics
NPI:1275538688
Name:BARLIS, ARTHUR A (MD PA)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:A
Last Name:BARLIS
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5848
Mailing Address - Country:US
Mailing Address - Phone:727-734-6593
Mailing Address - Fax:
Practice Address - Street 1:646 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6612
Practice Address - Country:US
Practice Address - Phone:727-734-6593
Practice Address - Fax:727-736-5866
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0016744174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049311200Medicaid
FL52722Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
FL049311200Medicaid
FL0538060001Medicare NSC