Provider Demographics
NPI:1447649967
Name:J.C.BARRIOS M.D LLC
Entity type:Organization
Organization Name:J.C.BARRIOS M.D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-381-4093
Mailing Address - Street 1:PO BOX 2262
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33568-2262
Mailing Address - Country:US
Mailing Address - Phone:813-381-4093
Mailing Address - Fax:877-991-9062
Practice Address - Street 1:16427 DUNLINDALE DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-4042
Practice Address - Country:US
Practice Address - Phone:813-381-4093
Practice Address - Fax:877-991-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME121590207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty