Provider Demographics
NPI:1588554125
Name:JUAN BARROSO PA
Entity type:Organization
Organization Name:JUAN BARROSO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARROSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-556-1699
Mailing Address - Street 1:6790 W 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6339
Mailing Address - Country:US
Mailing Address - Phone:305-556-1699
Mailing Address - Fax:305-556-6610
Practice Address - Street 1:6790 W 13TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6339
Practice Address - Country:US
Practice Address - Phone:305-556-1699
Practice Address - Fax:305-556-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty