Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | UO2721 | FL |
NPI | 1033486766 |
---|---|
Provider Name | Dr. Lauren Susan Hendrix |
First Address | Tampa, FL 33607-5906 |
Second Address | Tampa, FL 33607-5906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2011 |
Last Update Date | 15/04/2015 |