Healthcare Provider Details

I. General information

NPI: 1376879544
Provider Name (Legal Business Name): GARY S BARBER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 NW 9TH BLVD
GAINESVILLE FL
32605-4205
US

IV. Provider business mailing address

4131 NW 13TH STREET SUITE 101
GAINESVILLE FL
32609-1858
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-7987
  • Fax:
Mailing address:
  • Phone: 352-376-1887
  • Fax: 352-375-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1678092
License Number StateFL

VIII. Authorized Official

Name: MR. GARY STEVEN BARBER
Title or Position: OWNER
Credential: CRNA
Phone: 352-333-1995