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General NPI Number Information
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NPI Number | 1518317064
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Entity Type | Individual
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Provider Name | LEYDI BARROS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 7451 103RD ST UNIT 18
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City | JACKSONVILLE
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State | FL
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Zip | 32210-9300
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Country | US
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Telephone | 904-777-4622
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Fax |
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Provider Business Mailing Address
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Address Line | 7060 DEER LODGE CIR UNIT 102
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8566
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Country | US
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Telephone | 305-608-2005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21920
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License Number State | FL
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