Provider Demographics
NPI:1124409743
Name:BARRON, JUAN RICARDO
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:RICARDO
Last Name:BARRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 CALLE SAN JORGE STE 406
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912-3241
Mailing Address - Country:US
Mailing Address - Phone:787-726-0210
Mailing Address - Fax:
Practice Address - Street 1:252 CALLE SAN JORGE STE 406
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3241
Practice Address - Country:US
Practice Address - Phone:787-726-0210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-067121208000000X
PR210552080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics