Provider Demographics
NPI:1225532815
Name:BARBOSA CACERES, ZONIA G (MD)
Entity type:Individual
Prefix:
First Name:ZONIA
Middle Name:G
Last Name:BARBOSA CACERES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ZONIA
Other - Middle Name:
Other - Last Name:BARBOSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-430-2230
Mailing Address - Fax:606-218-4697
Practice Address - Street 1:911 BYPASS RD BLDG A
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1602
Practice Address - Country:US
Practice Address - Phone:606-430-3500
Practice Address - Fax:606-218-4697
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME147559208000000X
390200000X
KY59323208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program