Basic Information
| Provider Information | |||||||||
| NPI: | 1730100082 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARIA | ||||||||
| FirstName: | AUDREY | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2191 9TH AVE N | ||||||||
| Address2: | STE 110 | ||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337137146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278207778 | ||||||||
| FaxNumber: | 7278207779 | ||||||||
| Practice Location | |||||||||
| Address1: | 2191 9TH AVE N | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | SAINT PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337137146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278975282 | ||||||||
| FaxNumber: | 7273275657 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2006 | ||||||||
| LastUpdateDate: | 09/30/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME93269 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 16678 | 01 | FL | BCBS | OTHER | 2130114 | 01 | FL | UNITED | OTHER | 272933400 | 05 | FL | MEDICAID | 7229261 | 01 | FL | AETNA | OTHER | P01147546 | 01 | FL | RAILROAD MEDICARE | OTHER | 298204 | 01 | FL | AVMED | OTHER | 7418711 | 01 | FL | CIGNA | OTHER |