Provider Demographics
NPI:1932364494
Name:BARRY M CONCOOL MD LLC
Entity Type:Organization
Organization Name:BARRY M CONCOOL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONCOOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-525-7750
Mailing Address - Street 1:2300 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3254
Mailing Address - Country:US
Mailing Address - Phone:954-525-7750
Mailing Address - Fax:954-525-8660
Practice Address - Street 1:2300 N COMMERCE PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3254
Practice Address - Country:US
Practice Address - Phone:954-525-7750
Practice Address - Fax:954-525-8660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38137207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty