Elizabeth Marie Barroso, DMD

Individual provider Active NPI General Practice Dentistry · Yulee, FL

NPI 1013400613 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1013400613
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN25316 (FL)
Practice address
463787 State Road 200
Yulee, FL 32097-8652
Phone
(904) 875-4131
NPI assigned
Jun 8, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
34106TXMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mineral Wells, PLLC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN25316 FL Yes

Addresses

Primary practice location

463787 State Road 200
Yulee, FL 32097-8652

Mailing address

450 Slash Pine PL
Yulee, FL 32097-0096

Other providers in Yulee, FL

All providers in Yulee, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.