=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669146858
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANET BARRIOS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2021
-----------------------------------------------------
Last Update Date | 08/03/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14750 NW 44TH CT
-----------------------------------------------------
City | OPA LOCKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33054-2304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-953-2100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4742 NW 168TH TER
-----------------------------------------------------
City | MIAMI GARDENS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33055-4245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-546-2841
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 126800000X
-----------------------------------------------------
Taxonomy Name | Dental Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------