Provider Demographics
NPI:1649877200
Name:BARILE, SHALOM (APRN)
Entity type:Individual
Prefix:
First Name:SHALOM
Middle Name:
Last Name:BARILE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6520 FORT CAROLINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2044
Mailing Address - Country:US
Mailing Address - Phone:904-745-3618
Mailing Address - Fax:904-722-4271
Practice Address - Street 1:1372 PEACHTREE ST NE
Practice Address - Street 2:STE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3203
Practice Address - Country:US
Practice Address - Phone:470-964-1700
Practice Address - Fax:678-288-5639
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2025-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL11009461363LF0000X
FLAPRN11009461363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty