Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | ME104155 | FL |
N | 208200000X | Surgeon | ME104155 | FL |
N | 208600000X | Surgeon | ME104155 | FL |
NPI | 1255580080 |
---|---|
Provider Name | Dr. Heidi A Pearson |
First Address | Tampa, FL 33606-2707 |
Second Address | Tampa, FL 33606-2707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 08/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001237100 | (05) | FL |
CD600Y | MEDICARE PTAN (01) | FL |
Z00000 | (02) |