Healthcare Provider Details
I. General information
NPI: 1104005925
Provider Name (Legal Business Name): BRUCE D BARTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/29/2007
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 UNIVERSITY BLVD STE 102
JUPITER FL
33458-2788
US
IV. Provider business mailing address
9960 NW 116TH WAY STE 13
MEDLEY FL
33178-1175
US
V. Phone/Fax
- Phone: 561-909-0080
- Fax: 561-246-3338
- Phone: 786-924-1311
- Fax: 786-924-1313
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | ME0054358 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | ME54358 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: