=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649067497
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | INGRID N BARCO OSPINA PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2025
-----------------------------------------------------
Last Update Date | 04/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 420 S DIXIE HWY STE 4D
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-568-9000
-----------------------------------------------------
Fax | 305-856-9910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10670 SW 156TH PL APT 309
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33196-2795
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-459-5283
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT42860
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------