Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | ME0064363 | FL |
NPI | 1083695092 |
---|---|
Provider Name | Lizette Sonia Hernandez |
First Address | Tampa, FL 33614-4015 |
Second Address | Tampa, FL 33614-4015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2128888 | FIRST HEALTH (01) | FL |
291911 | AVMED HEALTH PLAN (01) | FL |
41857 | BCBS (01) | FL |
7080632 | AETNA HEALTH PLAN (01) | FL |