Provider Demographics
NPI:1871996876
Name:NARANJILLA, JOSE BARBAS JR (IDC)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:BARBAS
Last Name:NARANJILLA
Suffix:JR
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3D MED BN, 3D MLG
Mailing Address - Street 2:UNIT 38445
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96373
Mailing Address - Country:US
Mailing Address - Phone:098-970-6114
Mailing Address - Fax:
Practice Address - Street 1:3D MED BN, 3D MLG
Practice Address - Street 2:UNIT 38445
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96373
Practice Address - Country:US
Practice Address - Phone:098-970-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman