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NPI Code Detail

MEDICARE: BARRY W. CATES DMD

MEDICARE: BARRY W. CATES DMD
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
1122300000XDentist12289FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1677922OTHERFLUNITED CONCORDIA
263820OTHERFLBCBS

General Provider Information

NPI Number : 1639273279
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARRY W. CATES DMD
Provider Business Mailing Address
First Line : 926 GREAT POND DR STE 2003
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-7244
Country : US
Telephone Number : 407-772-5124
Fax Number : 407-788-3572
Provider Business Practice Location Address
First Line : 1515 S NOVA RD
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-5815
Country : US
Telephone Number : 386-947-9318
Fax Number : 386-947-4594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2006
Last Update Date : 11/15/2011

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