Provider Demographics
NPI:1669463501
Name:BARILE, MICHAEL GERALD (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GERALD
Last Name:BARILE
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 1:15495 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 119
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-6206
Mailing Address - Country:US
Mailing Address - Phone:239-221-3901
Mailing Address - Fax:239-221-3614
Practice Address - Street 1:15495 TAMIAMI TRL N
Practice Address - Street 2:SUITE 119
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-6206
Practice Address - Country:US
Practice Address - Phone:239-221-3901
Practice Address - Fax:239-221-3614
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75050207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255396100Medicaid
43811OtherBCBS
G41174Medicare UPIN
43811ZMedicare ID - Type Unspecified