Provider Demographics
NPI:1265596936
Name:MANKOWITZ, BARRY JOEL (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:JOEL
Last Name:MANKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:58477 MORTON ST
Mailing Address - Street 2:
Mailing Address - City:GRASSY KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33050-5724
Mailing Address - Country:US
Mailing Address - Phone:305-289-1771
Mailing Address - Fax:305-743-1887
Practice Address - Street 1:58477 MORTON ST
Practice Address - Street 2:
Practice Address - City:GRASSY KEY
Practice Address - State:FL
Practice Address - Zip Code:33050-5724
Practice Address - Country:US
Practice Address - Phone:305-289-1771
Practice Address - Fax:305-743-1887
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 213312086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery