Provider Demographics
NPI:1518001858
Name:BARRY, FERN SALZ
Entity Type:Individual
Prefix:
First Name:FERN
Middle Name:SALZ
Last Name:BARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 51ST ST W
Mailing Address - Street 2:#1914
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-5101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4802 51ST ST W
Practice Address - Street 2:#1914
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-5101
Practice Address - Country:US
Practice Address - Phone:941-773-4018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11485225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics