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NPI Code Detail

MEDICARE: MILISSA BARKER DPT

MEDICARE: MILISSA BARKER DPT
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
12081P0010XPediatric Rehabilitation Medicine Physician34475FL

General Provider Information

NPI Number : 1831971324
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILISSA BARKER DPT
Provider Business Mailing Address
First Line : 4352 SW JARMER RD
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34953-5634
Country : US
Telephone Number : 954-534-1804
Fax Number :
Provider Business Practice Location Address
First Line : 4352 SW JARMER RD
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34953-5634
Country : US
Telephone Number : 954-534-1804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2023
Last Update Date : 10/18/2023

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Directions to “ MILISSA BARKER DPT” Practice Location

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