Provider Demographics
NPI:1649581729
Name:JOHANNE Y. COMPAS-BARIL, M.D., P.A.
Entity Type:Organization
Organization Name:JOHANNE Y. COMPAS-BARIL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHANNE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:COMPAS-BARIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-239-6109
Mailing Address - Street 1:PO BOX 260424
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-7424
Mailing Address - Country:US
Mailing Address - Phone:954-239-6109
Mailing Address - Fax:866-283-5199
Practice Address - Street 1:8910 MIRAMAR PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4100
Practice Address - Country:US
Practice Address - Phone:954-239-6109
Practice Address - Fax:866-283-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98081207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71366OtherBC BS OF FLORIDA
FL000524100Medicaid
FL000524100Medicaid