1720573785 NPI number — MR. JOHN HENRY BARRASS II ATC, EMT

Table of content: MR. JOHN HENRY BARRASS II ATC, EMT (NPI 1720573785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720573785 NPI number — MR. JOHN HENRY BARRASS II ATC, EMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRASS
Provider First Name:
JOHN
Provider Middle Name:
HENRY
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
II
Provider Credential Text:
ATC, EMT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720573785
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19500 WHISPERING PINES RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUTLER BAY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33157-8865
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-444-8114
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7431 SW 120TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PINECREST
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33156-4635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-235-1360
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/22/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 146N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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