Provider Demographics
NPI:1316080393
Name:BARKLEY, LISA C (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:C
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3400 QUADRANGLE BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1492
Mailing Address - Country:US
Mailing Address - Phone:407-266-3627
Mailing Address - Fax:407-882-4814
Practice Address - Street 1:3400 QUADRANGLE BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1492
Practice Address - Country:US
Practice Address - Phone:407-266-3627
Practice Address - Fax:407-882-4814
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108870207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000822901Medicaid
DE062386Medicare UPIN
DE000822901Medicaid