Healthcare Provider Details

I. General information

NPI: 1659489698
Provider Name (Legal Business Name): JULIO C BARREDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST SUITE 407
MIAMI FL
33136-2137
US

IV. Provider business mailing address

1150 NW 14TH ST SUITE 407
MIAMI FL
33136-2137
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6837
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-243-6837
  • Fax: 305-243-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number15335
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME96664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: