Healthcare Provider Details

I. General information

NPI: 1407793730
Provider Name (Legal Business Name): RYAN STEPHEN BARKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 NW 89TH BLVD
GAINESVILLE FL
32606-3813
US

IV. Provider business mailing address

300 INTERNATIONAL PKWY
LAKE MARY FL
32746-5035
US

V. Phone/Fax

Practice location:
  • Phone: 352-554-9162
  • Fax:
Mailing address:
  • Phone: 866-610-0580
  • Fax: 866-611-1558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: