Provider Demographics
NPI:1902824857
Name:BARBEITO, MANUEL A (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:A
Last Name:BARBEITO
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 1:10887 NW 17TH ST UNIT 108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2044
Mailing Address - Country:US
Mailing Address - Phone:305-484-9205
Mailing Address - Fax:305-484-9205
Practice Address - Street 1:10887 NW 17TH ST UNIT 108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-2044
Practice Address - Country:US
Practice Address - Phone:305-484-9205
Practice Address - Fax:786-359-4999
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073319207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253210701Medicaid
FL253210701Medicaid
FL41354YMedicare PIN
FL41354XMedicare PIN