Healthcare Provider Details

I. General information

NPI: 1649510702
Provider Name (Legal Business Name): BARBARA SPARACINO, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3611 SW 87TH AVE SUITE 104
MIAMI FL
33165-4307
US

IV. Provider business mailing address

5600 COLLINS AVE APT. 14E
MIAMI BEACH FL
33140-2455
US

V. Phone/Fax

Practice location:
  • Phone: 305-815-7297
  • Fax:
Mailing address:
  • Phone: 305-815-7297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME111033
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberME11033
License Number StateFL

VIII. Authorized Official

Name: DR. BARBARA SPARACINO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-815-7297