Basic Information
Provider Information
NPI: 1598094229
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRIOS
FirstName: NADDIA
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 160 BOSTON AVE
Address2:  
City: ALTAMONTE SPRINGS
State: FL
PostalCode: 327014706
CountryCode: US
TelephoneNumber: 4077767654
FaxNumber: 4078346082
Practice Location
Address1: 160 BOSTON AVE
Address2:  
City: ALTAMONTE SPRINGS
State: FL
PostalCode: 327014706
CountryCode: US
TelephoneNumber: 4078347776
FaxNumber: 4078340973
Other Information
ProviderEnumerationDate: 12/08/2009
LastUpdateDate: 03/29/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XOPC4422FLY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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