Provider Demographics
NPI:1740263961
Name:BARBARITE, MARY (ARNP,MSN,BC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:BARBARITE
Suffix:
Gender:F
Credentials:ARNP,MSN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7541 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3510
Mailing Address - Country:US
Mailing Address - Phone:954-757-0140
Mailing Address - Fax:954-757-0150
Practice Address - Street 1:7541 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33073-3510
Practice Address - Country:US
Practice Address - Phone:954-757-0140
Practice Address - Fax:954-757-0150
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1423162363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU05272Medicare ID - Type Unspecified
FLP86510Medicare UPIN