Healthcare Provider Details

I. General information

NPI: 1477086544
Provider Name (Legal Business Name): BARBARO RAIMIS SAROSA CEPERO PMHNP-BC,FNP-C,APRN.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 DEL PRADO BLVD S STE 303
CAPE CORAL FL
33904-7222
US

IV. Provider business mailing address

9360 FONTAINEBLEAU BLVD APT D106
MIAMI FL
33172-5606
US

V. Phone/Fax

Practice location:
  • Phone: 239-317-0265
  • Fax: 239-673-7681
Mailing address:
  • Phone: 305-562-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9293729
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9293729
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: