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General NPI Number Information
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NPI Number | 1598433633
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Entity Type | Individual
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Provider Name | BIANCA T BARBOSA
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/03/2021
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Provider Practice Location Address
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Address Line | 1250 SOUTHWINDS DR
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City | LANTANA
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State | FL
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Zip | 33462-1459
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Country | US
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Telephone | 561-642-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 250 NW 67TH ST PHW
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City | BOCA RATON
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State | FL
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Zip | 33487-2927
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Country | US
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Telephone | 561-305-5846
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 26069
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License Number State | FL
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