Healthcare Provider Details

I. General information

NPI: 1669463501
Provider Name (Legal Business Name): MICHAEL GERALD BARILE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15495 TAMIAMI TRL N SUITE 119
NAPLES FL
34110-6206
US

IV. Provider business mailing address

15495 TAMIAMI TRL N SUITE 119
NAPLES FL
34110-6206
US

V. Phone/Fax

Practice location:
  • Phone: 239-221-3901
  • Fax: 239-221-3614
Mailing address:
  • Phone: 239-221-3901
  • Fax: 239-221-3614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME75050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: