Healthcare Provider Details

I. General information

NPI: 1619148517
Provider Name (Legal Business Name): ARTHUR A BARLIS M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 03/19/2008
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: 727-734-6175
  • Fax: 727-736-5866
Mailing address:
  • Phone: 727-734-6175
  • Fax: 727-736-5866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberME0016744
License Number StateFL

VIII. Authorized Official

Name: DR. ARTHUR A BARLIS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-734-6593