Provider Demographics
NPI:1649348772
Name:BARRON, JAMIE H (PSYD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:H
Last Name:BARRON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1269
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33539-1269
Mailing Address - Country:US
Mailing Address - Phone:813-780-8883
Mailing Address - Fax:813-788-6749
Practice Address - Street 1:37800 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-5428
Practice Address - Country:US
Practice Address - Phone:813-780-8883
Practice Address - Fax:813-788-6749
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0004548103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73799Medicare ID - Type Unspecified