Provider Demographics
NPI:1154619641
Name:MARGUERITE P. BARNETT MD, PA
Entity type:Organization
Organization Name:MARGUERITE P. BARNETT MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:PEARL
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:941-927-2447
Mailing Address - Street 1:1715 STICKNEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8869
Mailing Address - Country:US
Mailing Address - Phone:941-927-2447
Mailing Address - Fax:941-924-0762
Practice Address - Street 1:1715 STICKNEY POINT RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8869
Practice Address - Country:US
Practice Address - Phone:941-927-2447
Practice Address - Fax:941-924-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57523174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063770000Medicaid
FL063770000Medicaid