Healthcare Provider Details

I. General information

NPI: 1225071632
Provider Name (Legal Business Name): JOSEPH DONALD BARTA D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5463 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

IV. Provider business mailing address

5463 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

V. Phone/Fax

Practice location:
  • Phone: 352-596-3338
  • Fax: 352-597-3986
Mailing address:
  • Phone: 352-596-3338
  • Fax: 352-597-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO1749
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: