Healthcare Provider Details

I. General information

NPI: 1215141601
Provider Name (Legal Business Name): MICHAEL J BARIMO DO P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 N SEMORAN BLVD SUITE 206
WINTER PARK FL
32792-3800
US

IV. Provider business mailing address

483 N SEMORAN BLVD SUITE 206
WINTER PARK FL
32792-3800
US

V. Phone/Fax

Practice location:
  • Phone: 407-678-2400
  • Fax: 407-678-4926
Mailing address:
  • Phone: 407-678-2400
  • Fax: 407-678-4926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS5201
License Number StateFL

VIII. Authorized Official

Name: DR. MICHAEL J. BARIMO
Title or Position: OWNER
Credential: D.O.
Phone: 407-678-2400