Provider Demographics
NPI:1952681223
Name:BARROS, ANTONIO (LAC, DIPL OM)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:BARROS
Suffix:
Gender:M
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 TAYLOR RD UNIT 103
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-8338
Mailing Address - Country:US
Mailing Address - Phone:941-205-8649
Mailing Address - Fax:
Practice Address - Street 1:6025 TAYLOR RD UNIT 103
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-8338
Practice Address - Country:US
Practice Address - Phone:941-205-8649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4553171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist