Individual
MARY ROSE BAES BARRIOS-BANAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5270 BABCOCK ST NE, SUITE 1, PALM BAY, FL 32905-8630
(321) 676-5996
(321) 676-5926
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME115781
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/06/2010
Last updated
12/05/2013
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