Provider Demographics
NPI:1932568508
Name:BARRETO, EMANUEL J (MD)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:J
Last Name:BARRETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CALLE LOS PINOS
Mailing Address - Street 2:URB LA ESTANCIA
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-922-8760
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE SEVERO ARANA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2312
Practice Address - Country:US
Practice Address - Phone:787-680-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19627208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice