Provider Demographics
NPI:1245897685
Name:BARROSO, FRANK LUIS
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:LUIS
Last Name:BARROSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3353 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-3634
Mailing Address - Country:US
Mailing Address - Phone:954-200-4286
Mailing Address - Fax:
Practice Address - Street 1:3350 SW 148TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3237
Practice Address - Country:US
Practice Address - Phone:954-734-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician