Provider Demographics
NPI:1215019336
Name:BARZA, DORU DIMITRI (MD)
Entity Type:Individual
Prefix:DR
First Name:DORU
Middle Name:DIMITRI
Last Name:BARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 PGA BLVD
Mailing Address - Street 2:#214
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418
Mailing Address - Country:US
Mailing Address - Phone:561-627-5818
Mailing Address - Fax:561-627-4330
Practice Address - Street 1:5610 PGA BLVD
Practice Address - Street 2:#214
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3838
Practice Address - Country:US
Practice Address - Phone:561-627-5818
Practice Address - Fax:561-627-4330
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D63998Medicare UPIN
96799Medicare ID - Type Unspecified