MEDICARE: ADAM BARRAGAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS18969	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1417511742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM BARRAGAN DO

Provider Business Mailing Address
First Line	:	9015 TOWN CENTER PKWY UNIT 112
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-5012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9015 TOWN CENTER PKWY UNIT 112
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-5012
Country	:	US
Telephone Number	:	941-216-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2019
Last Update Date	:	06/15/2022

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Directions to “ ADAM BARRAGAN DO” Practice Location

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