Basic Information
| Provider Information | |||||||||
| NPI: | 1013015213 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARRERAS | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 S FEDERAL HWY | ||||||||
| Address2: | |||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330205424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543428800 | ||||||||
| FaxNumber: | 9543428700 | ||||||||
| Practice Location | |||||||||
| Address1: | 750 S FEDERAL HWY | ||||||||
| Address2: | |||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330205424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543428800 | ||||||||
| FaxNumber: | 9543428700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 09/15/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | ARNP 1534902 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | Y123L | 01 | BCBS | OTHER | 309071000 | 05 | FL | MEDICAID |