Healthcare Provider Details

I. General information

NPI: 1275538688
Provider Name (Legal Business Name): ARTHUR A BARLIS M.D. PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 VIRGINIA ST
DUNEDIN FL
34698-6612
US

IV. Provider business mailing address

601 MAIN ST
DUNEDIN FL
34698-5848
US

V. Phone/Fax

Practice location:
  • Phone: 727-734-6593
  • Fax: 727-736-5866
Mailing address:
  • Phone: 727-734-6593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0016744
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: