Healthcare Provider Details

I. General information

NPI: 1346377108
Provider Name (Legal Business Name): COSME B BARRETA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 ESTATE THOMAS VI MED FOUNDATION BLDG STE 201
ST. THOMAS VI
00802-2400
US

IV. Provider business mailing address

9150 ESTATE THOMAS VI MED FOUNDATION BLDG STE 201
ST. THOMAS VI
00802-2400
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-5665
  • Fax: 340-776-5448
Mailing address:
  • Phone: 340-774-5665
  • Fax: 340-776-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number174
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: