Provider Demographics
NPI:1457654733
Name:DORU BARZA M.D., PA
Entity Type:Organization
Organization Name:DORU BARZA M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DORU
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-627-5818
Mailing Address - Street 1:5610 PGA BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3838
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:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63998Medicare UPIN