Healthcare Provider Details

I. General information

NPI: 1720689821
Provider Name (Legal Business Name): STEVEN MICHAEL BARKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12294 INDIAN ROCKS RD
LARGO FL
33774-3001
US

IV. Provider business mailing address

14750 NW 77TH CT STE 100
MIAMI LAKES FL
33016-1507
US

V. Phone/Fax

Practice location:
  • Phone: 727-595-2534
  • Fax: 727-593-1773
Mailing address:
  • Phone: 786-758-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11010042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: