Healthcare Provider Details

I. General information

NPI: 1932879103
Provider Name (Legal Business Name): BRISTOL PALLIATIVE CARE SERVICES - FLORIDA, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 BLUE LAGOON DR STE 570
MIAMI FL
33126-2075
US

IV. Provider business mailing address

5201 BLUE LAGOON DR STE 570
MIAMI FL
33126-2075
US

V. Phone/Fax

Practice location:
  • Phone: 786-382-0433
  • Fax: 786-254-2556
Mailing address:
  • Phone: 786-382-0433
  • Fax: 786-254-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE E BARROS
Title or Position: MEMBER
Credential: MD
Phone: 762-382-0433