Healthcare Provider Details

I. General information

NPI: 1053477562
Provider Name (Legal Business Name): THOMAS FRANCIS BARRETT SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 TUSCANY BLVD
VENICE FL
34292-6637
US

IV. Provider business mailing address

1211 TUSCANY BLVD
VENICE FL
34292-6637
US

V. Phone/Fax

Practice location:
  • Phone: 941-492-4140
  • Fax: 941-493-7189
Mailing address:
  • Phone: 941-492-4140
  • Fax: 941-493-7189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number32620
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberME62121
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number35.03391
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number5035
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: