Individual
ELIAS IVAN COUTO BARBOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
820 PRUDENTIAL DR STE 304, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
655 WEST 8TH ST., ACC BLDG, 4TH FLOOR, JACKSONVILLE, FL 32209
(904) 383-1013
(904) 244-2165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME124789
FL
207RN0300X
Nephrology Physician
124789
FL
208M00000X
Hospitalist Physician
Primary
ME124789
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME124789
FLORIDA BOARD OF MEDICINE
FL
Enumeration date
05/22/2012
Last updated
03/20/2024
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