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Individual

DR. PROSPERO BARQUERO GOGO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 COLCHESTER AVE, FLETCHER ALLEN HEALTH CARE - CARDIOLOGY, BURLINGTON, VT 05401-1473
(802) 847-3602
(802) 847-0429
Mailing address
PO BOX 1063, FLETCHER ALLEN HEALTH CARE, BURLINGTON, VT 05402-1063
(802) 847-3602
(802) 847-0429

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
42-0010113
VT
207RI0011X
Interventional Cardiology Physician
Primary
42-0010113
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0VN2379
VT
Enumeration date
08/16/2005
Last updated
11/18/2013
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