Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME126769 | FL |
N | 207R00000X | Internist | ME126769 | FL |
N | 111NI0900X | Internist | ME126769 | FL |
N | 207RA0201X | Internist - Allergy & Immunology | ME126769 | FL |
NPI | 1013259407 |
---|---|
Provider Name | Dr. Amber Nardandrea Pepper |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33613-3923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2013 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100099100 | (05) | FL |
LYIUK | BLUE CROSS BLUE SHIELD (01) | FL |