Provider Demographics
NPI:1316733140
Name:BRITO, JUANCARLOS JUNIOR
Entity type:Individual
Prefix:
First Name:JUANCARLOS
Middle Name:JUNIOR
Last Name:BRITO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 PATICK CIRCLE SW UNIT E
Mailing Address - Street 2:
Mailing Address - City:BOLLING AFB
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2003
Mailing Address - Country:US
Mailing Address - Phone:954-410-8337
Mailing Address - Fax:
Practice Address - Street 1:5515 PATICK CIRCLE SW UNIT E
Practice Address - Street 2:
Practice Address - City:BOLLING AFB
Practice Address - State:DC
Practice Address - Zip Code:20032-2003
Practice Address - Country:US
Practice Address - Phone:954-410-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant