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General NPI Number Information
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NPI Number | 1588383624
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Entity Type | Individual
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Provider Name | LUIS FERNANDO PAES DE BARROS
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Gender | Male
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 3200 S UNIVERSITY DR
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City | DAVIE
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State | FL
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Zip | 33328-2018
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Country | US
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Telephone | 954-262-1776
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Fax | 954-262-7355
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Provider Business Mailing Address
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Address Line | 3200 S UNIVERSITY DR
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City | DAVIE
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State | FL
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Zip | 33328-2018
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Country | US
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Telephone | 954-262-1776
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Fax | 954-262-7355
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DTP757
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License Number State | FL
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