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General NPI Number Information
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NPI Number | 1770788689
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Entity Type | Individual
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Provider Name | MARTIN ACEVEDO BARRIOS MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 01/18/2016
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Provider Practice Location Address
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Address Line | 4881 PALM BEACH BLVD STE 100
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City | FORT MYERS
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State | FL
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Zip | 33905-3217
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Country | US
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Telephone | 813-380-4905
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Fax |
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Provider Business Mailing Address
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Address Line | 540 JETT DR
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City | JACKSON
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State | KY
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Zip | 41339-9622
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Country | US
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Telephone | 813-380-4905
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME98414
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 42222
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License Number State | KY
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