Provider Demographics
NPI:1588913842
Name:BARNEY, BYRON KENNETH
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:KENNETH
Last Name:BARNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10137 LANCASHIRE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32219-4367
Mailing Address - Country:US
Mailing Address - Phone:904-619-7059
Mailing Address - Fax:904-683-0222
Practice Address - Street 1:10137 LANCASHIRE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32219-4367
Practice Address - Country:US
Practice Address - Phone:904-619-7059
Practice Address - Fax:904-683-0222
Is Sole Proprietor?:No
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS445911835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS44591OtherPHARMACY LICENSE NUMBER