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General NPI Number Information
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NPI Number | 1922328228
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Entity Type | Organization
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Legal Business Name | JACQUELINE E BARRETT MD, PA
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 4651 SHERIDAN ST STE 450
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3415
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Country | US
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Telephone | 954-983-3355
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Fax |
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Provider Business Mailing Address
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Address Line | 4651 SHERIDAN ST STE 450
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3415
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Country | US
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Telephone | 954-983-3355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACQUELINE E BARRETT
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Credential | MD
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Telephone | 954-983-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | ME85154
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME85154
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME85154
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License Number State | FL
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