MEDICARE: DR. DORU DIMITRI BARZA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME46365	FL

General Provider Information

NPI Number	:	1215019336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DORU DIMITRI BARZA M.D.

Provider Business Mailing Address
First Line	:	5610 PGA BLVD
Second Line	:	#214
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418
Country	:	US
Telephone Number	:	561-627-5818
Fax Number	:	561-627-4330

Provider Business Practice Location Address
First Line	:	5610 PGA BLVD
Second Line	:	#214
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3838
Country	:	US
Telephone Number	:	561-627-5818
Fax Number	:	561-627-4330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	11/09/2011

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