Healthcare Provider Details

I. General information

NPI: 1902824857
Provider Name (Legal Business Name): MANUEL A BARBEITO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10887 NW 17TH ST UNIT 108
MIAMI FL
33172-2044
US

IV. Provider business mailing address

10887 NW 17TH ST UNIT 108
MIAMI FL
33172-2044
US

V. Phone/Fax

Practice location:
  • Phone: 305-484-9205
  • Fax: 786-359-4999
Mailing address:
  • Phone: 305-484-9205
  • Fax: 305-484-9205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME0073319
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME0073319
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: