Provider Demographics
NPI:1013907823
Name:LUX, BARBARA B (OD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:B
Last Name:LUX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:B
Other - Last Name:SHORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:570 HATFIELD DR
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:FL
Mailing Address - Zip Code:32784-8986
Mailing Address - Country:US
Mailing Address - Phone:352-669-6888
Mailing Address - Fax:352-669-1015
Practice Address - Street 1:570 HATFIELD DR
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:FL
Practice Address - Zip Code:32784-8986
Practice Address - Country:US
Practice Address - Phone:352-669-6888
Practice Address - Fax:352-669-1015
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC01802152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078809100Medicaid
FL078809100Medicaid
FL19474YMedicare PIN
FL19474Medicare PIN