Healthcare Provider Details

I. General information

NPI: 1174727853
Provider Name (Legal Business Name): MICHAEL BARBICK MD, DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16546 N DALE MABRY HWY
TAMPA FL
33618-1325
US

IV. Provider business mailing address

16546 N DALE MABRY HWY
TAMPA FL
33618-1325
US

V. Phone/Fax

Practice location:
  • Phone: 813-264-2286
  • Fax:
Mailing address:
  • Phone: 813-264-2286
  • Fax: 813-264-2091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number18016
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2010011430
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: