Provider Demographics
NPI:1598750564
Name:BARBERIS, CARLOS (MD)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:BARBERIS
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 1:1021 CESERY BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5609
Mailing Address - Country:US
Mailing Address - Phone:904-743-2466
Mailing Address - Fax:904-743-4070
Practice Address - Street 1:1021 CESERY BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5609
Practice Address - Country:US
Practice Address - Phone:904-743-2466
Practice Address - Fax:904-743-4070
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME33750207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD52709Medicare UPIN
FL21537Medicare ID - Type Unspecified