Healthcare Provider Details
I. General information
NPI: 1326143827
Provider Name (Legal Business Name): EDUARDO G BARROSO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/13/2006
Last Update Date: 01/28/2013
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
- Phone: 305-596-7878
- Fax: 305-271-3227
- Phone: 305-596-7878
- Fax: 305-271-3227
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0122X |
| Taxonomy | Plastic and Reconstructive Surgery Physician |
| License Number | ME0070041 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | ME0070041 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2082S0105X |
| Taxonomy | Surgery of the Hand (Plastic Surgery) Physician |
| License Number | ME0070041 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: