Healthcare Provider Details

I. General information

NPI: 1760315428
Provider Name (Legal Business Name): JAIR BARRIOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 S HAVERHILL RD
WEST PALM BEACH FL
33415-7350
US

IV. Provider business mailing address

2047 S HAVERHILL RD
WEST PALM BEACH FL
33415-7350
US

V. Phone/Fax

Practice location:
  • Phone: 561-543-2372
  • Fax:
Mailing address:
  • Phone: 561-543-2372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBACB1569345
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: