Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME0064337 | FL |
NPI | 1003817685 |
---|---|
Provider Name | Lisbeth Vernali |
First Address | Pensacola, FL 32503-2486 |
Second Address | Pensacola, FL 32503-2486 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
23704 | BCBS FLORIDA (01) | FL |
374066800 | (05) | FL |
F72872 | (02) | FL |
ME0064337 | LICENSE NUMBER (01) | FL |