Provider Demographics
NPI:1790777860
Name:BARTON, LORIS DOVER (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LORIS
Middle Name:DOVER
Last Name:BARTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:LORIS
Other - Middle Name:VIRGINIA
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:355 S ORCHID DR
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-2021
Mailing Address - Country:US
Mailing Address - Phone:941-729-1094
Mailing Address - Fax:
Practice Address - Street 1:712 39TH ST W
Practice Address - Street 2:MANATEE PEDIATRICS
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-2454
Practice Address - Country:US
Practice Address - Phone:941-748-4602
Practice Address - Fax:941-747-9230
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1336322363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics