Provider Demographics
NPI:1063787612
Name:BOHRER, BARRY (CPED)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:BOHRER
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1429
Mailing Address - Country:US
Mailing Address - Phone:305-793-5728
Mailing Address - Fax:305-513-5942
Practice Address - Street 1:150 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1429
Practice Address - Country:US
Practice Address - Phone:305-793-5728
Practice Address - Fax:305-513-5942
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPED 194174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist