Provider Demographics
NPI:1881019636
Name:BARBA, IGNACIO R
Entity Type:Individual
Prefix:
First Name:IGNACIO
Middle Name:R
Last Name:BARBA
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 1:4445 W 16TH AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7189
Mailing Address - Country:US
Mailing Address - Phone:305-826-4570
Mailing Address - Fax:305-827-1404
Practice Address - Street 1:4445 W 16TH AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7189
Practice Address - Country:US
Practice Address - Phone:305-826-4570
Practice Address - Fax:305-827-1404
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT386882471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography