Provider Demographics
NPI:1538121298
Name:MISKIN, BARRY MARC (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:MARC
Last Name:MISKIN
Suffix:
Gender:M
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:PO BOX 8068
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-8068
Mailing Address - Country:US
Mailing Address - Phone:618-184-4145
Mailing Address - Fax:561-745-4470
Practice Address - Street 1:210 JUPITER LAKES BLVD STE 3105
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7189
Practice Address - Country:US
Practice Address - Phone:561-745-7789
Practice Address - Fax:561-755-8745
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2021-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051970208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05850OtherBCBS
CO57785562Medicaid
FL0064761OtherGHI
FL3702024OtherUNITED HEALTHCARE
FL3702024OtherUNITED HEALTHCARE
CO57785562Medicaid
COC807716Medicare PIN