MEDICARE: DR. MIGUEL A BARBOSA 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	208D00000X	General Practice Physician	ME52896	FL

General Provider Information

NPI Number	:	1285855478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIGUEL A BARBOSA M.D.

Provider Business Mailing Address
First Line	:	4404 FLAGG ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8018
Country	:	US
Telephone Number	:	407-376-1610
Fax Number	:	407-249-9466

Provider Business Practice Location Address
First Line	:	4404 FLAGG ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8018
Country	:	US
Telephone Number	:	407-376-1610
Fax Number	:	407-249-9466

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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