Provider Demographics
NPI:1932879103
Name:BRISTOL PALLIATIVE CARE SERVICES - FLORIDA, L.L.C.
Entity Type:Organization
Organization Name:BRISTOL PALLIATIVE CARE SERVICES - FLORIDA, L.L.C.
Other - Org Name:BRISTOL ADVANCED ILLNESS MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:762-382-0433
Mailing Address - Street 1:5201 BLUE LAGOON DR STE 570
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2075
Mailing Address - Country:US
Mailing Address - Phone:786-382-0433
Mailing Address - Fax:786-254-2556
Practice Address - Street 1:5201 BLUE LAGOON DR STE 570
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2075
Practice Address - Country:US
Practice Address - Phone:786-382-0433
Practice Address - Fax:786-254-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty