Healthcare Provider Details

I. General information

NPI: 1073132445
Provider Name (Legal Business Name): SUSANA BARREIRO SACCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4302 ALTON RD STE 490
MIAMI BEACH FL
33140-2842
US

IV. Provider business mailing address

4302 ALTON RD STE 490
MIAMI BEACH FL
33140-2842
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2798
  • Fax: 305-674-2799
Mailing address:
  • Phone: 305-674-2798
  • Fax: 305-674-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number22326
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: