Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP 1534902 | FL |
NPI | 1013015213 |
---|---|
Provider Name | Linda C Barreras |
First Address | Hollywood, FL 33020-5424 |
Second Address | Hollywood, FL 33020-5424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 15/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
309071000 | (05) | FL |
Y123L | BCBS (01) |