Individual
DR. MARK A BARRAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3600
(904) 390-3491
Mailing address
PO BOX 191, PROVIDER ENROLLMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME97140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277026100
—
FL
05
—
687539028A
—
GA
Enumeration date
07/05/2006
Last updated
10/18/2011
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