Healthcare Provider Details

I. General information

NPI: 1780158667
Provider Name (Legal Business Name): PATRICIA BARROS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-1698
  • Fax: 954-262-3882
Mailing address:
  • Phone: 954-262-1698
  • Fax: 954-262-3882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDN24677
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: