Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | ME40455 | FL |
NPI | 1003894692 |
---|---|
Provider Name | Juan Luis Barrio |
First Address | Miami, FL 33173-3253 |
Second Address | Miami, FL 33173-3253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 09/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043417500 | (05) | FL |
D63979 | (02) | FL |