Provider Demographics
NPI:1831200898
Name:BARBA, ALICE RENEE (MD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:RENEE
Last Name:BARBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 BISCAYNE BLVD STE 1140
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3247
Mailing Address - Country:US
Mailing Address - Phone:305-573-7200
Mailing Address - Fax:305-573-7092
Practice Address - Street 1:4770 BISCAYNE BLVD STE 1140
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3247
Practice Address - Country:US
Practice Address - Phone:305-573-7200
Practice Address - Fax:305-573-7092
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82656174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3601BMedicare ID - Type Unspecified
FLE3601CMedicare ID - Type Unspecified
FLH49323Medicare UPIN