MEDICARE: DR. ERNESTO BARRAL 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	208000000X	Pediatrics Physician	ME94471	FL

General Provider Information

NPI Number	:	1801842133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNESTO BARRAL M.D.

Provider Business Mailing Address
First Line	:	1511 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-5478
Country	:	US
Telephone Number	:	772-337-4208
Fax Number	:	772-337-4211

Provider Business Practice Location Address
First Line	:	1511 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-5478
Country	:	US
Telephone Number	:	772-337-4208
Fax Number	:	772-337-4211

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	12/19/2024

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