Provider Demographics
NPI:1235111519
Name:BARIA, MANISH B (MD)
Entity Type:Individual
Prefix:
First Name:MANISH
Middle Name:B
Last Name:BARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:305-812-1654
Mailing Address - Fax:
Practice Address - Street 1:901 22ND AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-2933
Practice Address - Country:US
Practice Address - Phone:727-310-0925
Practice Address - Fax:727-376-9426
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90993207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015027300Medicaid
FL270444700Medicaid
FL270444700Medicaid
I16068Medicare UPIN
FL015027300Medicaid