Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | ME88958 | FL |
NPI | 1447365424 |
---|---|
Provider Name | Dr. Denise Aviva Sherman |
First Address | Tampa, FL 33613-6601 |
Second Address | Tampa, FL 33613-6601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 04/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
268368700 | (05) | FL |
H71234 | (02) |