Provider Demographics
NPI:1477540144
Name:CARIDAD BARRIOS, JORGE ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ALBERTO
Last Name:CARIDAD BARRIOS
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 1:372 W 47TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3950
Mailing Address - Country:US
Mailing Address - Phone:305-698-0112
Mailing Address - Fax:305-698-0169
Practice Address - Street 1:372 W 47TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3950
Practice Address - Country:US
Practice Address - Phone:305-698-0112
Practice Address - Fax:305-698-0169
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46364208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029471300Medicaid
FLE31302Medicare UPIN
FL96754Medicare ID - Type Unspecified