Healthcare Provider Details

I. General information

NPI: 1417210527
Provider Name (Legal Business Name): LORA DAPHNA YASOVA BARBEAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

3055 NW 84TH TER
PEMBROKE PINES FL
33024-5297
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0477
  • Fax:
Mailing address:
  • Phone: 727-455-0773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17248
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME124788
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: