Provider Demographics
NPI:1851403489
Name:BLOCK, BARRY R (DPM)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:R
Last Name:BLOCK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1001 N FEDERAL HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2400
Mailing Address - Country:US
Mailing Address - Phone:954-454-5221
Mailing Address - Fax:954-458-4232
Practice Address - Street 1:1001 N FEDERAL HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2400
Practice Address - Country:US
Practice Address - Phone:954-454-5221
Practice Address - Fax:954-458-4232
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO0623213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT92343Medicare UPIN
FL87282Medicare ID - Type Unspecified