Provider Demographics
NPI:1265187058
Name:BARNEY, KARIN (GPTA)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:BARNEY
Suffix:
Gender:F
Credentials:GPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 BEACON DR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5620
Mailing Address - Country:US
Mailing Address - Phone:814-935-2840
Mailing Address - Fax:
Practice Address - Street 1:4161 TAMIAMI TRL STE 704
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9283
Practice Address - Country:US
Practice Address - Phone:941-625-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31819208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation