Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME0076558 | FL |
NPI | 1013966951 |
---|---|
Provider Name | Gio J Baracco |
First Address | Aventura, FL 33180-3751 |
Second Address | Miami, FL 33125-1624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 20/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H27476 | (02) | FL |