Healthcare Provider Details

I. General information

NPI: 1881051332
Provider Name (Legal Business Name): SHAUN BARBER APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 E ALTAMONTE DR STE 206
ALTAMONTE SPRINGS FL
32701-4810
US

IV. Provider business mailing address

616 E ALTAMONTE DR STE 206
ALTAMONTE SPRINGS FL
32701-4810
US

V. Phone/Fax

Practice location:
  • Phone: 407-270-2473
  • Fax:
Mailing address:
  • Phone: 407-270-2473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9271673
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9271673
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: