Provider Demographics
NPI:1306935630
Name:CHAMBERLAIN, BARBARA (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 JFK DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1146
Mailing Address - Country:US
Mailing Address - Phone:561-964-1215
Mailing Address - Fax:561-964-1245
Practice Address - Street 1:110 JFK DR
Practice Address - Street 2:SUITE 118
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1146
Practice Address - Country:US
Practice Address - Phone:561-964-1215
Practice Address - Fax:561-964-1245
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL51744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057179OtherNHP
FL195486OtherWELLCARE
FL262808200Medicaid
FL5681514OtherAETNA
FLSG030924OtherVISTA
FL297523OtherAVMED
FL000004206916OtherHEALTHY PALM BEACHES
FL1727173002OtherCIGNA
FL08768OtherBLUE CROSS BLUE SHIELD