Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME0051394 | FL |
NPI | 1043265358 |
---|---|
Provider Name | Dr. Fernando Barquero |
First Address | Hialeah, FL 33010 |
Second Address | Miami, FL 33155-1436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 07/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E34600 | (02) | FL |