Provider Demographics
NPI:1942765482
Name:BARACUSA HEALTH CARE CORP
Entity Type:Organization
Organization Name:BARACUSA HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARGUIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-452-0257
Mailing Address - Street 1:7235 CORAL WAY STE 204B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1451
Mailing Address - Country:US
Mailing Address - Phone:786-452-0257
Mailing Address - Fax:786-536-9248
Practice Address - Street 1:7235 CORAL WAY STE 204B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1451
Practice Address - Country:US
Practice Address - Phone:786-452-0257
Practice Address - Fax:786-536-9248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities