Provider Demographics
NPI:1093132870
Name:BARBERA, YUDERCA
Entity Type:Individual
Prefix:
First Name:YUDERCA
Middle Name:
Last Name:BARBERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 CORPORATE SQ
Mailing Address - Street 2:STE 153
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4714
Mailing Address - Country:US
Mailing Address - Phone:239-331-9690
Mailing Address - Fax:
Practice Address - Street 1:4100 CORPORATE SQ
Practice Address - Street 2:STE 153
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-4714
Practice Address - Country:US
Practice Address - Phone:239-331-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005937900Medicaid