MEDICARE: AHMED PEREZ BARROSO C-SA

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	246ZS0410X	Surgical Technologist	11-247	FL

General Provider Information

NPI Number	:	1497164024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED PEREZ BARROSO C-SA

Provider Business Mailing Address
First Line	:	8260 SW 27 TR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155
Country	:	US
Telephone Number	:	305-823-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	8260 SW 27 TR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155
Country	:	US
Telephone Number	:	305-823-5000
Fax Number	:

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

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	08/07/2014

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