Provider Demographics
NPI:1356665012
Name:BARRERA BERMEJO, JOSE MIGUEL (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:MIGUEL
Last Name:BARRERA BERMEJO
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 1:3601 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3300
Mailing Address - Country:US
Mailing Address - Phone:305-775-0412
Mailing Address - Fax:
Practice Address - Street 1:3601 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3300
Practice Address - Country:US
Practice Address - Phone:305-775-0412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL121509207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology