Provider Demographics
NPI:1164430427
Name:BARRERAS, JUAN XAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:XAVIER
Last Name:BARRERAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:138 AVE WINSTON CHURCHILL
Mailing Address - Street 2:PMB 318
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6013
Mailing Address - Country:US
Mailing Address - Phone:787-462-4555
Mailing Address - Fax:787-357-7514
Practice Address - Street 1:102 CARR INT KM 15.4
Practice Address - Street 2:112 HACIENDAS DEL GOLF
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-462-4555
Practice Address - Fax:787-357-7514
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15960208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-15902-0Medicare UPIN
PR2-3748Medicare ID - Type Unspecified