Provider Demographics
NPI:1710122254
Name:LUIS BARRERAS JR MD PA
Entity Type:Organization
Organization Name:LUIS BARRERAS JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:954-771-0692
Mailing Address - Street 1:6405 N FEDERAL HWY
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1412
Mailing Address - Country:US
Mailing Address - Phone:954-771-0692
Mailing Address - Fax:954-771-0760
Practice Address - Street 1:6405 N FEDERAL HWY
Practice Address - Street 2:SUITE 300B
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1412
Practice Address - Country:US
Practice Address - Phone:954-771-0692
Practice Address - Fax:954-771-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty