Provider Demographics
NPI:1730100082
Name:BARIA, AUDREY P (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:P
Last Name:BARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2191 9TH AVE N
Mailing Address - Street 2:STE 110
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7146
Mailing Address - Country:US
Mailing Address - Phone:727-820-7778
Mailing Address - Fax:727-820-7779
Practice Address - Street 1:2191 9TH AVE N
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7146
Practice Address - Country:US
Practice Address - Phone:727-897-5282
Practice Address - Fax:727-327-5657
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16678OtherBCBS
FL2130114OtherUNITED
FL272933400Medicaid
FL7229261OtherAETNA
FLP01147546OtherRAILROAD MEDICARE
FL298204OtherAVMED
FL7418711OtherCIGNA
FLH21848Medicare UPIN
FL7229261OtherAETNA