Provider Demographics
NPI:1013015213
Name:BARRERAS, LINDA C (ARNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:BARRERAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-5424
Mailing Address - Country:US
Mailing Address - Phone:954-342-8800
Mailing Address - Fax:954-342-8700
Practice Address - Street 1:750 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-5424
Practice Address - Country:US
Practice Address - Phone:954-342-8800
Practice Address - Fax:954-342-8700
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1534902363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y123LOtherBCBS
FL309071000Medicaid