Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME87588 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME87588 | FL |
NPI | 1861416844 |
---|---|
Provider Name | Dr. Jessica Brooke Feranec |
First Address | Orlando, FL 32827-7401 |
Second Address | Orlando, FL 32827-7401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 13/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
274386800 | (05) | FL |
I10515 | (02) |