Basic Information
| Provider Information | |||||||||
| NPI: | 1487831418 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARROSO | ||||||||
| FirstName: | TANIA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 470 16TH ST NW | ||||||||
| Address2: | APT 4021 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303631097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047364673 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1441 CLIFTON RD NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047125527 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2008 | ||||||||
| LastUpdateDate: | 01/22/2008 | ||||||||
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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 | 208100000X | 2741 | GA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.