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Individual

JERRY LEVY BARBOSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 5TH STREET SOUTH, SUITE 302, ST PETERSBURG, FL 33701
(727) 767-4176
(727) 767-4379
Mailing address
601 5TH ST S, SUITE 320, ST PETERSBURG, FL 33701-4804
(727) 767-4176
(727) 767-4379

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0026819
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
057182200
FL
Enumeration date
06/22/2005
Last updated
09/22/2011
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