Healthcare Provider Details

I. General information

NPI: 1427971993
Provider Name (Legal Business Name): BRYAN BARAHONA OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 VETERANS WAY
ORLANDO FL
32827-7401
US

IV. Provider business mailing address

560 NW 116TH ST
MIAMI FL
33168-3417
US

V. Phone/Fax

Practice location:
  • Phone: 407-631-1000
  • Fax:
Mailing address:
  • Phone: 786-333-0184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: