Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME97200 | FL |
Y | 2080P0205X | Pediatric Endocrinologist | ME97200 | FL |
NPI | 1093908048 |
---|---|
Provider Name | Anne M. Lenz |
First Address | Orlando, FL 32891-7770 |
Second Address | St Petersburg, FL 33701-4634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 01/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002644200 | (05) | FL |
149U6 | BLUE CROSS BLUE SHIELD (01) | FL |