Provider Demographics
NPI:1932557444
Name:DIBARTOLO-BARCLAY, ERICA LEA (LM, LMT)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LEA
Last Name:DIBARTOLO-BARCLAY
Suffix:
Gender:F
Credentials:LM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12527 KILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-1451
Mailing Address - Country:US
Mailing Address - Phone:352-584-5113
Mailing Address - Fax:
Practice Address - Street 1:400 E PALM AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-2717
Practice Address - Country:US
Practice Address - Phone:813-515-0825
Practice Address - Fax:813-358-3865
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW331176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife