Provider Demographics
NPI:1942265897
Name:SPLATER, BARBARA
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:SPLATER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-5377
Mailing Address - Country:US
Mailing Address - Phone:904-384-2554
Mailing Address - Fax:904-388-7769
Practice Address - Street 1:4623 CAMBRIDGE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-5377
Practice Address - Country:US
Practice Address - Phone:904-384-2554
Practice Address - Fax:904-388-7769
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor