MEDICARE: MRS. BARBARA L PARKER LPN, LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN0476611	FL
2	225700000X	Massage Therapist	MA5326	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C5866	OTHER	FL	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1659387884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA L PARKER LPN, LMT

Provider Business Mailing Address
First Line	:	1858 SE LAKE WEIR AVE
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-5427
Country	:	US
Telephone Number	:	352-732-8919
Fax Number	:	352-732-8919

Provider Business Practice Location Address
First Line	:	1858 SE LAKE WEIR AVE
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-5427
Country	:	US
Telephone Number	:	352-732-8919
Fax Number	:	352-732-8919

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	01/30/2008

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