Provider Demographics
NPI:1568233286
Name:BARBOSA, CARLOS ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:BARBOSA
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:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0061
Mailing Address - Country:US
Mailing Address - Phone:787-565-9581
Mailing Address - Fax:
Practice Address - Street 1:URB. MARTORELL D2
Practice Address - Street 2:CALLE L. MUNOZ RIVERA
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-2707
Practice Address - Country:US
Practice Address - Phone:787-565-9581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1960-PA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical