Healthcare Provider Details

I. General information

NPI: 1104180223
Provider Name (Legal Business Name): REBECCA ARCEBIDO BARROS PHARMD, BCACP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HEALTH PARK BLVD
ST AUGUSTINE FL
32086-5784
US

IV. Provider business mailing address

547 CLERMONT CT
WESTON FL
33326-2992
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-4037
  • Fax:
Mailing address:
  • Phone: 954-384-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number056254
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS50872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: