Barraza, Mark A

Barraza, Mark A is an individual health care provider with primary practice located at 807 Childrens Way , Jacksonville FL 32207-8426. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Barraza, Mark A can be contacted via phone (904) 390-3600.

Contact Information

Primary practice address
807 Childrens Way Jacksonville FL 32207-8426
Phone: (904) 390-3600
Fax: (904) 390-3491
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X ME97140 Florida

Profile Details

NPI number 1346271772
LBN Legal business name Barraza, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Oct 18th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346271772 NPPES
Georgia MEDICAID 687539028A
Georgia MEDICAID 277026100

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