Healthcare Provider Details

I. General information

NPI: 1699869131
Provider Name (Legal Business Name): SOLOMON BARRERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COLUMBIA OUTPATIENT SURGICAL SERVICES 301 NORTHWEST 82ND AVE
PLANATION FL
33324
US

IV. Provider business mailing address

PO BOX 17347
PLANTATION FL
33318-7347
US

V. Phone/Fax

Practice location:
  • Phone: 954-424-1766
  • Fax:
Mailing address:
  • Phone: 954-370-1053
  • Fax: 954-370-1533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME29442
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: