Provider Demographics
NPI:1386808749
Name:PUENTES, BARBARO
Entity type:Individual
Prefix:MR
First Name:BARBARO
Middle Name:
Last Name:PUENTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S MILITARY TRL
Mailing Address - Street 2:SUITE F2
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-5720
Mailing Address - Country:US
Mailing Address - Phone:561-433-4051
Mailing Address - Fax:561-433-4052
Practice Address - Street 1:1401 S MILITARY TRL
Practice Address - Street 2:SUITE F2
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-5720
Practice Address - Country:US
Practice Address - Phone:561-433-4051
Practice Address - Fax:561-433-4052
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM21613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor