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General NPI Number Information
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NPI Number | 1538121298
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Entity Type | Individual
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Provider Name | BARRY MARC MISKIN MD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 12/25/2021
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Provider Practice Location Address
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Address Line | 210 JUPITER LAKES BLVD STE 3105
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City | JUPITER
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State | FL
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Zip | 33458-7189
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Country | US
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Telephone | 561-745-7789
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Fax | 561-755-8745
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Provider Business Mailing Address
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Address Line | PO BOX 8068
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City | JUPITER
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State | FL
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Zip | 33468-8068
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Country | US
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Telephone | 618-184-4145
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Fax | 561-745-4470
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME0051970
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License Number State | FL
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