MEDICARE: SUYING DEL CARMEN LAM BARRIGA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME113310	FL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2080P0202X	Pediatric Cardiology Physician	ME113310	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124348107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUYING DEL CARMEN LAM BARRIGA MD

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-343-7490
Fax Number	:	239-343-5032

Provider Business Practice Location Address
First Line	:	16281 BASS RD
Second Line	:	SUITE 304
City	:	FORT MYERS
State	:	FL
Zip	:	33908-9687
Country	:	US
Telephone Number	:	239-343-7490
Fax Number	:	239-343-5032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2010
Last Update Date	:	03/29/2021

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