Provider Demographics
NPI:1336148535
Name:RESNIK, BARRY ISAAC (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ISAAC
Last Name:RESNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21097 NE 27TH CT STE 580
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1246
Mailing Address - Country:US
Mailing Address - Phone:305-692-8998
Mailing Address - Fax:305-692-8606
Practice Address - Street 1:21097 NE 27TH CT STE 580
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1246
Practice Address - Country:US
Practice Address - Phone:305-692-8998
Practice Address - Fax:305-692-8606
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60934207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F26996Medicare UPIN
FL14923AMedicare ID - Type Unspecified