MEDICARE: PAUL J BARRESE MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME 41807	FL

General Provider Information

NPI Number	:	1063734689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL J BARRESE MD PA

Provider Business Mailing Address
First Line	:	3909 E BAY DR
Second Line	:	SUITE 210
City	:	HOLMES BEACH
State	:	FL
Zip	:	34217-1997
Country	:	US
Telephone Number	:	941-778-2271
Fax Number	:	941-778-1311

Provider Business Practice Location Address
First Line	:	3909 E BAY DR
Second Line	:	SUITE 210
City	:	HOLMES BEACH
State	:	FL
Zip	:	34217-1997
Country	:	US
Telephone Number	:	941-778-2271
Fax Number	:	941-778-1311

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL JOSEPH BARRESE
Credential	:	M.D.
Telephone Number	:	941-778-2271

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	02/23/2010

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