Provider Demographics
NPI:1497769673
Name:BARCO, CARLOS MANUEL
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:MANUEL
Last Name:BARCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 W FLAGLER ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1586
Mailing Address - Country:US
Mailing Address - Phone:305-446-1354
Mailing Address - Fax:305-446-1737
Practice Address - Street 1:4343 W FLAGLER ST
Practice Address - Street 2:SUITE 404
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1586
Practice Address - Country:US
Practice Address - Phone:305-446-1354
Practice Address - Fax:305-446-1737
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA39439225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist