MEDICARE: ODALYS BARROSO

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	225200000X	Physical Therapy Assistant	PTA 25897	FL

General Provider Information

NPI Number	:	1437509809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ODALYS BARROSO

Provider Business Mailing Address
First Line	:	8585 NW 6TH LN APT 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3852
Country	:	US
Telephone Number	:	786-252-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	8585 NW 6TH LN APT 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3852
Country	:	US
Telephone Number	:	786-252-2211
Fax Number	:

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

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	06/16/2016

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Directions to “ ODALYS BARROSO ” Practice Location

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