Healthcare Provider Details

I. General information

NPI: 1336326685
Provider Name (Legal Business Name): EDUARDO G BARROSO M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6141 SUNSET DR SUITE 100
SOUTH MIAMI FL
33143-5028
US

IV. Provider business mailing address

6141 SUNSET DR SUITE 100
SOUTH MIAMI FL
33143-5028
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-7878
  • Fax: 305-271-3227
Mailing address:
  • Phone: 305-596-7878
  • Fax: 305-271-3227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME0070041
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberME0070041
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME0070041
License Number StateFL

VIII. Authorized Official

Name: DR. EDUARDO BARROSO
Title or Position: PRESIDENT
Credential: MD
Phone: 305-596-7878