Individual
WAYNE BARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 SAXON BLVD.,, FLORIDA HOSPITAL FISH MEMORIAL, ORANGE CITY, FL 32763
(386) 917-5434
(386) 917-5101
Mailing address
397 CADDIE DR, DEBARY, FL 32713-4514
(386) 917-0811
(386) 917-0812
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME51146
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04618
BLUE CROSS OF FLORIDA
FL
01
—
221871
AMERIGROUP
FL
05
—
257134000
—
FL
01
—
P30090443
RAILROAD MEDICARE
FL
Enumeration date
06/05/2006
Last updated
06/19/2019
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