Healthcare Provider Details

I. General information

NPI: 1669771259
Provider Name (Legal Business Name): JODIE ADAM BARKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST STE 1188
MIAMI FL
33136-2107
US

IV. Provider business mailing address

1120 NW 14TH ST STE 1188
MIAMI FL
33136-2107
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-8644
  • Fax:
Mailing address:
  • Phone: 305-243-8644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME131039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: