Healthcare Provider Details

I. General information

NPI: 1306935630
Provider Name (Legal Business Name): BARBARA CHAMBERLAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 JFK DR SUITE 118
ATLANTIS FL
33462-1146
US

IV. Provider business mailing address

110 JFK DR SUITE 118
ATLANTIS FL
33462-1146
US

V. Phone/Fax

Practice location:
  • Phone: 561-964-1215
  • Fax: 561-964-1245
Mailing address:
  • Phone: 561-964-1215
  • Fax: 561-964-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number51744
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: