Provider Demographics
NPI:1609964733
Name:BARR, FREDRIC M (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDRIC
Middle Name:M
Last Name:BARR
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 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE 5800
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3404
Mailing Address - Country:US
Mailing Address - Phone:561-833-1142
Mailing Address - Fax:561-833-4206
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 5800
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-833-1142
Practice Address - Fax:561-833-4206
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME35302208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069865200Medicaid
FL61364Medicare ID - Type Unspecified
FL069865200Medicaid