Healthcare Provider Details

I. General information

NPI: 1710181540
Provider Name (Legal Business Name): THE BARRANCO CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1397 WHISPER CIR
SEBRING FL
33870-1205
US

IV. Provider business mailing address

160 E LAKE HOWARD DR
WINTER HAVEN FL
33881-3155
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-4800
  • Fax: 863-382-0761
Mailing address:
  • Phone: 863-299-1251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DEANE R BRIGGS
Title or Position: PARTNER
Credential: M.D.
Phone: 863-299-1251