MEDICARE: DR. MARLA OBARA 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	207R00000X	Internal Medicine Physician	ME0053418	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	:	1902894280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLA OBARA MD

Provider Business Mailing Address
First Line	:	5911 TROUBLE CREEK RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-5128
Country	:	US
Telephone Number	:	727-847-5352
Fax Number	:	727-847-3923

Provider Business Practice Location Address
First Line	:	5911 TROUBLE CREEK RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-5128
Country	:	US
Telephone Number	:	727-847-5352
Fax Number	:	727-847-3923

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	09/21/2012

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