Provider Demographics
NPI:1619148517
Name:ARTHUR A BARLIS M.D.
Entity Type:Organization
Organization Name:ARTHUR A BARLIS M.D.
Other - Org Name:SUNCOAST EYEWEAR BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-734-6593
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:727-734-6175
Mailing Address - Fax:727-736-5866
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:727-734-6175
Practice Address - Fax:727-736-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0016744332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0538060001Medicare NSC