Provider Demographics
NPI:1487625844
Name:BARNETT, MARGUERITE PEARL (MD)
Entity Type:Individual
Prefix:MISS
First Name:MARGUERITE
Middle Name:PEARL
Last Name:BARNETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 STICKNEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8869
Mailing Address - Country:US
Mailing Address - Phone:941-927-2447
Mailing Address - Fax:941-924-0762
Practice Address - Street 1:1715 STICKNEY POINT RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8869
Practice Address - Country:US
Practice Address - Phone:941-927-2447
Practice Address - Fax:941-924-0762
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057523208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063770000Medicaid
11393Medicare ID - Type Unspecified
E66579Medicare UPIN