Provider Demographics
NPI:1871791392
Name:BARNOUTI, ANWAR NAIF (M D)
Entity type:Individual
Prefix:DR
First Name:ANWAR
Middle Name:NAIF
Last Name:BARNOUTI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2473 CASTELLON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2601
Mailing Address - Country:US
Mailing Address - Phone:904-733-9957
Mailing Address - Fax:
Practice Address - Street 1:2473 CASTELLON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2601
Practice Address - Country:US
Practice Address - Phone:904-733-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine