Healthcare Provider Details

I. General information

NPI: 1700382256
Provider Name (Legal Business Name): STEVEN BARILLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 HOLLYWOOD BLVD STE 301
HOLLYWOOD FL
33021-6745
US

IV. Provider business mailing address

4000 HOLLYWOOD BLVD STE 215S
HOLLYWOOD FL
33021-1227
US

V. Phone/Fax

Practice location:
  • Phone: 954-961-1200
  • Fax:
Mailing address:
  • Phone: 954-807-9332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME156566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: