MEDICARE: DR. CARLOS MANUEL BARROSO 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	ME 45745	FL

General Provider Information

NPI Number	:	1841365657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS MANUEL BARROSO M.D.

Provider Business Mailing Address
First Line	:	780 E 8TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4546
Country	:	US
Telephone Number	:	305-888-7955
Fax Number	:

Provider Business Practice Location Address
First Line	:	456 W 51ST PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3620
Country	:	US
Telephone Number	:	305-819-7770
Fax Number	:	305-819-8898

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/08/2007

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