Provider Demographics
NPI:1093251720
Name:BARCUS, THERESA (LAP, DOM, MOA, CAIT)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:BARCUS
Suffix:
Gender:F
Credentials:LAP, DOM, MOA, CAIT
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:BARCUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAP, DOM, MOA, CAIT
Mailing Address - Street 1:3912 LA FLOR DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5333
Mailing Address - Country:US
Mailing Address - Phone:941-879-7388
Mailing Address - Fax:
Practice Address - Street 1:3190 SUNTREE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5741
Practice Address - Country:US
Practice Address - Phone:941-879-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3476171100000X, 175L00000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175L00000XOther Service ProvidersHomeopath
No174H00000XOther Service ProvidersHealth Educator