MEDICARE: MR. DANIEL ROBERT BARKER

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	246RP1900X	Phlebotomy Technician	0600659152	FL

General Provider Information

NPI Number	:	1477577252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL ROBERT BARKER

Provider Business Mailing Address
First Line	:	4121 SE 18TH AVE
Second Line	:	#B
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-6010
Country	:	US
Telephone Number	:	239-540-1846
Fax Number	:	239-540-1846

Provider Business Practice Location Address
First Line	:	4121 SE 18TH AVE
Second Line	:	#B
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-6010
Country	:	US
Telephone Number	:	239-540-1846
Fax Number	:	239-540-1846

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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