Provider Demographics
NPI:1982384723
Name:DE LA BARRA, MARIA AIDEE ERIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:AIDEE ERIKA
Last Name:DE LA BARRA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:13911 LAKESHORE BLVD STE 111
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7102
Practice Address - Country:US
Practice Address - Phone:727-869-8800
Practice Address - Fax:727-869-8814
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2024-04-23
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Provider Licenses
StateLicense IDTaxonomies
FLACN1611208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice